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DENTAL   MEDICINE. 


F.  J.  S.  GORGAS  M.  D. 


DENTAL  MEDICINE; 


A  MANUAL 


Dental  Materia  Medica 


AND  THERAPEUTICS, 


PRACTITIONERS  AND  STUDENTS. 


FERDINAND  J.   S.  GORGAS,    A.M.,  M.D.,  D.D.S., 

KuiTOR  OF  "Harris'  Principles  and  Practice  of  Dentistry,"  and  "Harris'  Diction- 
ary OF  Medical  Terminology  and  Dental  Surgery,"  Professor  of 
THE  Principles  of  Dental  Science,  Dental  Surgery, 
ETC.,  IN  THE  Dental  Department  of  the 
University   of  Maryland, 
Baltimore. 


PHILADELPHIA: 
P.    BLAKISTON,   SON    &   CO., 

IOI2  Walnut  Street. 

1884. 


?K7or 

0;  ■ 


Entered  according  to  Act  of  Congress,  in  the  year  1883,  by 

P.  BLAKISTON,  SON  &  CO., 

In  the  Office  of  the  Librarian  of  Congress,  at  Washington,  D.  C. 


PREFACE. 


This  work  has  been  prepared  by  the  author  in  deference 
to  many  requests  from  former  pupils,  and  has  been  compiled 
from  lectures  delivered  by  him  in  dental  institutions  during 
the  past  twenty-five  years,  and  notes  obtained  from  the  stand- 
ard works  on  Materia  Medica  and  Therapeutics,  and  also  from 
personal  experience  as  a  dental  practitioner  and  teacher. 

While  the  author  claims  the  credit  of  the  compilation,  he 
does  not  claim  originality  in  the  sources,  derivations,  medical 
properties  and  action  of  the  various  articles  of  dental  materia 
medica  which  are  given  in  this  work. 

His  intention  has  been  to  present  not  alone  his  own  ideas 
as  to  the  particular  application  of  remedies,  but  also  those  of 
well  known  and  acknowledged  authorities,  and  in  such  a  man- 
ner as  may  be  of  service  to  the  dental  student  in  acquiring  a 
knowledge  of  this  important  branch  of  his  profession ;  hence 
nothing  has  been  presented  in  this  work  that,  in  the  author's 
opinion,  is  not  applicable  to  dental  practice,  and  that  will  not 
be  of  benefit  to  the  dental  student. 


VI  PREFACE. 

The  dental  formulary  comprises  many  valuable  combina- 
tions, and  credit  has  been  given,  in  every  case  where  it  was 
possible,  to  the  authors  of  the  different  preparations. 

The  necessity  for  an  American  work  of  this  kind  has  long 

been   apparent,   and    after   years  pf  delay   and    promises   the 

author  gratefully  dedicates  this  work  to  his  former  pupils  in 

the  dental  institutions  with  which  he  has  been  and  is  now 

connected,  in  the  capacity  of  a  teacher. 

Hamilton  Terrace,  Baltimore, 
January,  1884. 


CONTENTS. 


PAGE 

Preface v 

Introduction  and  Definitions  and  General  Remarks 9 

Action  of  Medicinal  Substances 10 

Important  Points  in  Diagnosing  Affections  of  the  Mouth 12 

Characteristic  Indications  of  the  Tongue 22 

Abbreviations  with  Latin  and  English  Terms 22 

Approximate  Measurements 23 

Fineness  of  Powder 24 

Weights  and  Measures 25 

Metric  or  French  Decimal  System  of  Weights  and  Measures 25 

Rules  for  Regulating  Doses 29 

Table  of  Doses  of  all  Officinal  Medicines,  Expressed  in  Terms  of  Both  the 

Apothecaries,  and  the  Decimal  Metric  System  of  Weights  and  Measures,  31 

Poisons — Symptoms  and  Antidotes 46 

The  Pulse 53 

Pulsation  per  Minute  at  Various  Ages 54 

Respiration  at  Various  Ages  56 

Thermometers 56 

Table  of  Elementary  Substances 57 

Table  of  the  Solubility  of  Chemicals  in  Water  and  Alcohol 58 

Classification  of  Medicinal  Substances 61 

Definitions  of  the  Various  Classes  of  Medicinal  Agents 61 

Forms  in  which  Medicinal  Substances  are  Employed 87 

Source,  Derivation,  Medical  Properties  and  Action,  and  Therapeutic  Uses  of 
Medicinal   Substances   Employed  in   Dental   Practice  ;  Together  with 

their  Dental  Uses  and  Application , 90 

vii 


viii  CONTENTS. 

PAGE 

Administration  of  General  Anesthetic  Agents 134 

The  Dangers  of  Ansesthesia I37 

Preventive  Measures  Against  the  Dangers  of  Ansesthesia 137 

Treatment  of  Dangerous  Symptoms  of  Ansesthesia  , 138 

Methods  of  Resuscitation — Sylvester's  Method — Hall's  Ready  Method 139 

Local  Anaesthesia 141 

Topical  Remedies 289 

The  Endermic  Method , 289 

The  Hypodermic  Method 289 

Setons  and  Issues 290 

General  Bloodletting 291 

Local  Bloodletting  by  Leeching,  Cupping  and  Scarifications 291 

Periods  for  the  Eruption  of  the  Teeth 292 

Electricity  as  a  Therapeutic  Means  in  the  Treatment  of  Disease 293 

Authorities  Consulted 299 

Index  to  Dental  Formulary , 301 

General  Index 305 


DENTAL  MEDICINE. 


INTRODUCTION. 


DEFINITION   OF   SUBJECTS. 

Materia  Medica  is  that  branch  of  medical  science  which 
refers  to  and  describes  the  substances  known  as  "  medicinal 
agents,"  which  are  employed  in  the  prevention  and  treatment 
of  disease. 

Therapeutics  is  that  branch  of  medical  science  which  com- 
prises the  doctrine  of  the  management  of  disease.  Generally, 
however,  the  term  is  restricted  to  a  description  of  the  modus 
operandi  of  medicines,  or,  in  other  words,  their  use  and  effects 
when  applied  in  the  treatment  of  various  morbid  conditions. 
An  accurate  knowledge  of  the  principles  and  rules  which 
govern  the  administration  and  action  of  medicinal  substances 
enables  the  practitioner  to  restore  disordered  functions,  and  to 
so  impress  the  organism  as  to  maintain  harmonious  conditions, 
by  means  of  which  the  various  functions,  in  a  state  of  health, 
are  intimately  connected  by  relation  and  sympathy. 

Some  medicinal  agents  exert  their  influence  on  primary 
nourishment,  converting  food,  by  digestion,  into  the  substance 
of  organic  beings,  while  other  remedies,  without  interfering 
with  digestion,  by  a  modification  of  the  process  of  assimilation, 
exert  a  destructive  influence  upon  the  tissues.  Some  medi- 
cinal agents  affect  the  nervous  system,  and  others  are  so  irri- 
tant in  their  effects  as  to  cause  their  speedy  expulsion.;  while 
2  9 


10  DENTAL    MEDICINE. 


others,  again,  have  a  particular  affinity  for  certain  organs,  and 
are  eliminated  by  them,  the  effects  ceasing  as  soon  as  the  evacu- 
ation is  completed. 

What  are  known  as  topical  or  external  remedies  act  directly 
upon  the  parts  to  which  they  are  applied,  and  their  general 
effects  are  produced  through  the  nervous  system. 

GENERAL  REMARKS. 

In  every  case,  the  first  object  should  be  to  ascertain  and, 
if  possible,  remove  the  cause  of  a  disease.  It  should  be 
remembered  that  medicinal  substances  are  always  more 
certain  in  their  action  when  applied  directly  to  the  affected 
tissue;  also,  that  chemical,  physical  and  vital  changes  result 
from  the  topical  action  of  such  substances ;  and  that  age 
modifies  the  effects,  and  also  determines  the  dose ;  also  scx^ 
owing  to  the  greater  susceptibility  of  the  nervous  system  in 
females  than  in  males  ;  also  the  temperament,  as  the  sanguine, 
for  example,  is  more  susceptible  to  the  influence  of  medicinal 
agents  than  the  phlegmatic  ;  also  habit  and  mode  of  life,  as  the 
habitual  use  of  such  agents  as  stimulants  lessens  their  influence, 
and  the  occupation  affects  the  susceptibility  to  external  influ- 
ence ;  also  the  co7tdition  of  the  body,  as  different  diseases  exer- 
cise considerable  influence  on  the  effects  of  medicinal  sub- 
stances ;  also  the  mind,  as  a  hopeful  mind  conduces  to  the 
beneficial  action  of  medicines;  also  idiosyncrasy,  zs,  some  indi- 
viduals are  more  susceptible  to  the  action  or  effects  of  medi- 
cinal substances  than  others ;  also  the  nature  of  the  tissue  or 
organ  to  which  application  is  made,  as  some  are  more  suscep- 
tible to  the  effect  of  medicinal  agents  than  others,  owing  to 
rapidity  of  absorption  and  the  degree  of  decomposition  of  the 
substance  employed ;  also  climate,  from  the  recognized  in- 
fluence of  climate  in  modifying  the  structure  and  functions  of 
the  animal  economy,  and  in  increasing  or  diminishing  morbid 
conditions,  and  by  such  means  influencing  the  effects  of  medi- 
cinal agents. 

In  most  acute  diseases  there  is  a  tendency  to  recovery  after 
a  certain  time  has  elapsed,  in  case  there  is  no  failure  in  the 


GENERAL   REMARKS.  11 


functions  of  any  of  the  essential  organs  ;  hence,  in  all  acute 
diseases,  the  state  of  the  nervous  system  should  be  carefully 
watched. 

In  acute  inflammations  a  dilatation  of  the  smaller  arteries  of 
the  structure  is  first  observed,  and  an  increased  rapidity  of 
the  current  of  the  blood  through  them.  The  capillaries  and 
smaller  veins  soon  become  filled  with  blood  cells,  and  the 
rapidity  of  the  stream  gradually  lessens  until  stagnation  oc- 
curs. The  white  corpuscles  escape  in  large  numbers  through 
the  walls  of  the  capillaries,  and  distend  the  surrounding  struc- 
tures. In  many  cases,  where  the  cause  ceases  to  act,  the  parts 
gradually  resume  their  normal  condition.  But  when  the  cause 
continues  to  act  as  a  local  irritant,  the  vascular  and  nervous 
systems  become  excited.  The  contractions  of  the  heart  in- 
crease in  rapidity  and  force,  the  temperature  of  the  body  is 
augmented,  and  other  symptoms  of  the  nervous  centres  make 
their  appearance. 

When  the  affection  is  not  of  a  serious  character,  such  symp- 
toms as  are  especially  troublesome  maybe  relieved;  but  when 
the  nervous  and  vascular  systems  are  affected,  both  locally  and 
generally,  then  it  is  necessary  that  the  proper  measures  for 
their  relief  be  promptly  taken. 

Where  mucous  membrane  is  the  seat  of  the  affection,  it  is 
often  possible  to  remove  the  exciting  cause.  There  are  also 
many  inflammatory  affections  met  with,  where,  from  the  be- 
ginning, there  is  a  diminished  action  of  the  heart,  and  a 
depressed  state  of  the  nervous  centres.  In  the  treatment  of 
such  cases,  the  depressed  condition  of  the  general  system 
chiefly  requires  attention,  as  the  progress  and  termination  of 
the  local  affection  depend  upon  the  cause  from  which  it  has 
originated. 

There  are  also  morbid  states  not  necessarily  dependent  on 
organic  disease.  Various  acids  are  produced  by  the  ferment- 
ation of  substances  containing  starch  or  sugar,  and  there  is 
reason  for  believing  that  an  increased  secretion  of  acid  may 
take  place  from  the  mucous  membrane  of  the  stomach  and 
produce  symptoms  of  acidity  independently  of  fermentation, 


12  DENTAL    MEDICINE, 


although  one  of  the  properties  of  the  gastric  fluid  is  to  prevent 
fermentation.  The  symptoms  of  acidity  are  a  sour  taste,  and 
the  occurrence  of  acid  eructations,  often  accompanied  with 
heartburn,  and  sometimes  with  diarrhoea,  and  a  feehng  of  sink- 
ing at  the  epigastrium. 

In  these  cases  the  cause  must  be  sought  for,  and  such  treat- 
ment instituted  as  will  neutralize  the  acidity  and  stimulate  the 
peptic  glands  to  an  increased  secretion  of  the  digestive  fluid ; 
also  such  as  will  regulate  the  bowels.  Due  attention  must 
also  be  given  to  the  diet,  which  should  consist  of  such  sub- 
stances as  will  not  readily  ferment,  and  all  food  containing 
starch  should  be  avoided. 

Although  topical  remedies  are  more  generally  employed  in 
the  treatment  of  dental  affections,  yet  there  are  many  diseases 
of  the  oral  cavity  which  are  due  to  remote  causes,  and  require 
constitutional  as  well  as  local  treatment. 

The  appearances  presented  by  the  mucous  membrane  of  the 
mouth  are  valuable,  as  indicating  the  state  of  other  parts  more 
remote ;  and  it  is  frequently  the  case  that,  when  the  constitu- 
tional affection  is  overcome,  the  local  symptoms  disappear  as 
a  consequence,  or  become  very  amenable  to  local  remedies. 

IMPORTANT  POINTS  IN  DIAGNOSING  AFFEC- 
TIONS  OF  THE   MOUTH. 

TJie  Irritation  of  TeetJiing  is  indicated  by  a  hot,  swollen  and 
tender  condition  of  the  gums,  fretfulness,  irritable  temper, 
refusal  of  nourishment,  fever  and  thirst,  and,  if  not  relieved, 
diarrhoea  with  offensive  motions,  sometimes  a  troublesome 
cough,  convulsions,  and  other  serious  results. 

An  Abnormal  Dentition  is  indicated  by  a  hot,  dry  mouth, 
swollen  gums,  tense,  tender  and  shining,  fever,  disordered 
bowels,  fretfulness,  eruption  on  skin,  diarrhoea,  convulsions. 

Convulsions  of  Dentition  are  indicated  by  such  premonitory 
symptoms  as  irritable  temper,  unusual  brightness  of  eyes, 
indisposition  to  eat  or  sleep,  slight  involuntary  movements  of 
muscles  of  face  or  extremities,  grinding  of  teeth.  The  par- 
oxysm is  indicated  by  rigidity  of  body,  utterances  of  a  cry, 


DIAGNOSIS    OF    MOUTH    AFFECTIONS.  13 

face  turning  red  or  purple,  veins  of  neck  turgid,  suspension  of 
respiration,  loss  of  consciousness,  irregular  and  intermittent 
contraction  of  muscles,  protrusion  of  tongue,  frothing  at  lips, 
distortion  of  face,  rolling  of  eyeballs,  contracted  and  rapid 
pulse. 

Inflannnation  of  the  Dental  Periosteum  is  indicated  by  a  sense 
of  uneasiness  and  fullness,  which  is  at  first  relieved  by  pressure, 
but  after  active  inflammation  is  established,  pressure  on  the 
affected  tooth  causes  intense  pain.  The  tooth  is  also  protruded, 
to  a  slight  degree,  from  the  alveolus,  and  also  somewhat 
loosened,  owing  to  the  thickening  of  the  investing  membrane  ; 
and  the  inflammation,  which  is  at  first  manifested  by  a  red  line 
near  the  margin  of  the  gum,  becomes  general  over  the  entire 
root,  sometimes  involving  the  neighboring  gum,  and  even  the 
palate  and  cheek,  with  pain  of  a  constant  character,  and  symp- 
toms of  febrile  disturbance.  A  modification  of  the  symptoms 
just  enumerated,  the  tooth  being  tender  to  pressure,  more  or 
less  raised  in  its  cavity,  and  surrounded  by  a  reddened  and 
swollen  gum,  with  a  varying  amount  of  pain,  and  the  discharge 
of  pus  from  around  the  neck,  or  from  a  fistulous  opening  in 
the  gum,  and  such  symptoms  continuing  for  a  long  time, 
indicate  the  chronic  form  of  an  advanced  stage  of  dental  peri- 
ostitis. 

Alveolai^  Abscess  is  first  indicated  by  pain  of  a  constant  char- 
acter, which  is  afterwards  aggravated  at  each  pulsation  ;  then 
swelling  about  the  root  of  the  affected  tooth,  which  at  length 
becomes  defined  and  prominent,  and  afterwards  points  and  dis- 
charges pus,  when  the  active  symptoms  subside.  The  devel- 
opment of  alveolar  abscess  is  indicated  by  such  constitutional 
symptoms  as  foul  tongue,  offensive  breath,  hot  skin,  thirst  and 
headache,  and,  when  the  suppuration  is  considerable,  symp- 
tomatic fever  and  rigors. 

The  characteristic  pain  of  an  alveolar  abscess  is  deep-seated 
and  throbbing,  and,  with  the  swelling,  denotes  the  formation 
of  pus.  A  chronic  form  of  alveolar  abscess  is  indicated  by  a 
subsidence  of  the  active  symptoms,  and  a  continuance  of  the 
discharge  of  small  quantities  of  pus  through  a  fistulous  open- 


14  DENTAL    MEDICINE. 


ing  opposite  the  root  of  the  affected  tooth,  or  about  its  neck. 
An  elastic  fluctuating  swelling  in  any  part  of  the  face,  or  for 
some  distance  down  the  neck,  may  result  from  abscessed  teeth. 

Alveolar  Abscess  about  to  point  Externally  is  indicated  by  the 
skin,  for  some  distance  around  a  central  point,  becoming  red 
and  distended,  with  a  throbbing  sensation,  succeeded  by  a 
change  in  the  appearance  of  the  skin  to  a  thin  and  scaly 
surface,  from  which  the  epidermis  scales  off  The  integument 
becomes  glued  down  to  the  bone  around  the  spot  where  the 
pus  will  ultimately  appear ;  the  latter  following  a  fistulous 
track  between  the  diseased  tooth  and  the  surface  of  the  cheek, 
the  fistula  remaining  open  and  discharging  as  long  as  the 
inflammatory  action  continues. 

Abscess  of  the  Antrum  is  indicated  by  a  discharge  of  pus  into 
the  nose,  sometimes  producing  scarcely  any  discomfort ;  at 
other  times  the  severest  local  and  constitutional  suffering  ;  an 
aching  pain  in  the  cheek,  which  is  hot,  flushed  and  somewhat 
swollen ;  and  as  the  symptoms  increase,  greater  pain,  of  a 
throbbing  character,  with  the  rigors  and  fever  peculiar  to 
suppuration  ;  an  expansion  of  the  bone  of  the  upper  jaw ;  an 
elevation  of  the  malar  bone,  with  a  very  apparent  depression 
beneath  it ;  the  molar  teeth  on  the  affected  side  depressed  so  as 
to  appear  elongated  and  to  prevent  the  proper  closure  of  the 
mouth ;  an  increase  of  pus ;  the  palate  losing  its  concavity 
and  becoming  convex ;  the  nostril  of  the  affected  side  being 
encroached  upon,  and,  in  protracted  cases,  the  floor  of  the  orbit 
of  the  eye  so  pushed  up  as  to  force  the  eye  partly  from  its 
socket ;  the  sight  affected  by  the  stretching  of  the  optic  nerve  ; 
the  walls  of  the  antrum  becoming  so  thin  as  to  afford  evidence 
of  fluid  fluctuation  on  pressure ;  at  length  the  pus  escaping 
through  the  cheek,  or  into  the  nose,  or  burrowing  along  the 
side  of  a  root  of  a  tooth  and  discharging  into  the  mouth  ;  the 
floor  of  the  orbit  giving  way  and  the  pus  discharging  along  the 
lower  eyelid. 

Necrosis  of  the  Alveolar  Process  is  indicated  by  a  dark 
purple  and  swollen  condition  of  gum,  with  offensive  purulent 
discharge. 


DIAGNOSIS    OF    MOUTH    AFFECTIONS.      '  15 

Fracture  of  the  Alveolar  Process  is  indicated  by  a  swollen, 
red  and  painful  state  of  gum  and  tissues  covering  maxillary- 
bone,  occurring  some  days  after  the  receipt  of  the  injury,  and, 
if  neglected,  may  result  in  necrosis  of  the  bone. 

Phosphor-Necrosis  is  indicated  by  pain  in  jaw,  similar  to 
odontalgia,  at  first  not  constant,  but  soon  becoming  severe,  and 
extending  along  side  of  the  head,  and  to  the  shoulder,  with 
swelling  and  great  tenderness  near  the  seat  of  the  affection,  the 
integument  becoming  red  and  tense,  the  teeth  elongated  and 
extremely  painful  when  closed  together,  and  also  becoming 
loose ;  the  gums  and  mucous  membrane  of  the  cheeks  swollen 
and  livid ;  at  length,  suppuration  ensuing,  with  fever,  rigors, 
etc.;  gums  becoming  spongy,  with  escape  of  pus  around  necks 
of  necrosed  teeth,  and  the  pus  fetid,  and  the  swelling  very 
great,  especially  when  the  lower  jaw  is  affected;  a  dense  plastic 
exudation  encasing  the  under  and  external  surface  of  the 
bone ;  intense  glistening  redness  of  the  skin,  as  the  pus 
approaches  the  surface ;  at  length,  intense  fever,  with  delirium 
and  great  suffering ;  the  throwing  out  of  a  bony  deposit  of  a 
peculiar  appearance,  like  pumice-stone. 

Mercurial  Poisoning,  or  Salivation,  when  of  a  mild  form,  is 
indicated  by  a  red  margin  of  the  gum,  which  eventually 
becomes  somewhat  spongy  and  tender,  with  a  slight  fetor  of  the 
breath  and  a  metallic  taste. 

An  increased  degree  of  salivation,  or  imrcurial  stomatitis,  is 
indicated  by  a  profuse  flow  of  saliva,  intense  fetor,  strong 
metallic  taste,  tenderness  of  the  gums,  stiffness  of  the  jaws, 
followed  by  ulceration  and  sloughing,  if  the  injudicious  use  of 
the  mercury  is  persisted  in. 

Lead  Poisoning  is  indicated  by  a  blue  line  upon  the  edge  of 
the  gums,  and  such  constitutional  symptoms  as  paralysis  and 
colic  attend  severe  cases. 

Sciirvy  is  indicated  by  a  general  spongy  condition  of  the 
gums,  and,  in  severe  cases,  intense  fetor,  ulceration  and  slough- 
ing, together  with  constitutional  symptoms  of  an  aggravated 
character.     Some  varieties   of  salivary  calculus  will  produce 


16  DENTAL    MEDICINE. 


similar  local  symptoms,  especially  when  the  general  condition 
of  the  system  is  unfavorable. 

A  Simple  Form  of  Stomatitis  is  indicated  by  slightly  elevated, 
reddish,  glistening  patches,  on  the  mucous  membrane,  which 
may  coalesce,  so  that  the  whole  surface  is  involved. 

Ulcerative  Stomatitis  is  indicated  by  ulceration  commencing 
on  or  near  the  gums,  more  frequently  in  the  lower  than  in  the 
upper  jaw,  and  usually  on  one  side  only,  and  spreading  over 
the  entire  mouth.  The  gum  first  becomes  thickened  and 
congested,  and  of  a  deep  purple  color,  and  bleeds  readily;  ulcera- 
tion speedily  occurs,  and  exposes  the  necks  of  the  teeth,  and 
extends  to  the  mucous  membrane  of  the  mouth  generally,  the 
ulcerated  surface  being  covered  with  a  dirty  white  or  yellow 
exudation,  leaving  exposed  numerous  bright  red  points  on  a 
yellowish  ground.  The  edges  of  the  ulcers  are  sharp  and 
ragged,  and  the  ulcer,  at  first  superficial,  becomes  gradually 
deeper.  Ulcers  of  the  mouth  are  often  due  to  syphilis  and 
dyspepsia,  and  are  aggravated  by  the  irritation  resulting  from 
the  irregular  edges  of  fractured  and  decayed  teeth.  When 
neglected,  such  ulcers  may  assume  the  appearance  of  epithe- 
lioma, especially  when  induration  of  the  glands  beneath  the 
jaw  is  present. 

Ulcers  of  the  Month  due  to  Syphilis  are  indicated  when  such 
ulceration  is  obstinate  under  any  but  specific  treatment,  and 
when  accompanied  by  symptoms  peculiar  to  syphilis. 

Syphilitic  Inflammation  of  the  Mucous  Membrane  of  the 
Mouth  is  indicated  by  a  general  swelling  of  the  gums,  with 
everted  and  ulcerated  margins,  exposing  the  necks  of  the  teeth, 
although  not  affecting,  to  any  great  degree,  their  stability,  with 
a  viscid  discharge,  mixed  with  blood,  from  about  their  necks ; 
soreness,  rendering  mastication  painful ;  the  affection  slowly 
spreading,  until  the  bone  is  exposed,  and  a  portion  exfoliated ; 
greater  degree  of  congestion ;  formation  of  mucous  patches 
on  sides  of  cheeks ;  superficial  ulcers  on  inside  of  cheeks  and 
beneath  the  tongue ;  erosions  of  the  soft  palate  and  tonsils  ; 
fissures  at  corner  of  the  mouth,  and  eruptions  on  skin  and 
scalp. 


DIAGNOSIS    OF    MOUTH    AFFECTIONS.  17 

Gangrenous  Stomatitis  is  indicated  by  a  thick  swelling  of  the 
face ;  skin  tense  and  shining ;  swelling  becoming  hard  and 
circumscribed,  but  devoid  of  tenderness,  with  a  central  spot, 
red  and  variegated  in  appearance ;  the  formation  of  an  ulcer, 
corresponding  to  the  red  spot  outside,  on  the  inside  of  the 
cheek ;  profuse  salivation,  the  ulcerated  part  becoming  gan- 
grenous, with  an  opening  through  the  cheek ;  absence  of  pain 
and  destruction  of  parts. 

A  Tiiuior  of  the  Upper  Jaiu  is  indicated  by  a  gradually 
increasing  prominence  of  the  cheek,  which  more  or  less  involves 
the  mouth,  obstructing  the  nostril,  causing  double  vision  by 
displacing  the  eyeball. 

A  Malignant  Form  of  Tumor  of  the  Jaws  is  indicated  by  a 
solid  prominence,  rapid  in  growth,  and  having  a  tendency  to 
invade  surrounding  structures,  and  to  fungate  like  a  mushroom. 

A  Dentigerons  Cyst  is  indicated  by  the  expansion  of  the  bone 
of  the  jaw  at  some  particular  spot,  with  disfigurement  of  the 
adjacent  parts ;  a  sense  of  weight  and  tension  in  the  affected 
part ;  in  some  cases,  constitutional  irritation  from  pressure ; 
pressure  producing  a  parchment-like  crackle  or  crepitation  ; 
absence  of  a  tooth  which  has  never  been  erupted  nor  extracted. 

An  Unerupted  Impacted  Tooth  is  indicated  by  a  hard,  bony 
tumor  on  the  alveolar  ridge,  sometimes  extending  along  the 
surface  of  the  palate  bone  or  the  body  of  the  maxilla,  and  in 
form  corresponding  to  a'tooth,  the  absence  of  which  is  noted. 

Necrosis  of  the  Jaw  is  indicated  by  inflammation  like  that  of 
dental  periostitis  in  the  early  stage,  but  differing  as  the  disease 
progresses ;  gum  over  affected  part  thickened,  tumid  and  of  a 
red  color ;  pus  oozing  from  the  edge  of  gum,  which  soon  sepa- 
rates from  the  alveolus,  the  margins  of  which  become  exposed  ; 
loosening  and  loss  of  the  teeth  ;  the  detachment  of  the  dead 
alveoli  from  the  living  bone,  and  remaining  loose  in  the 
substance  of  the  thickened  gum,  surrounded  by  pus  ;  the 
escape  of  the  pus  into  the  mouth,  or  pointing  below  the  chin, 
or  beneath  the  fascia  of  the  neck,  as  low  at  times  as  the  clavicle. 

Dislocation  of  the  Lower  Jaw,  when  double,  is  indicated  by 
inability  to  close  the  mouth  ;  the  mouth  widely  open  ;  the  chin 


18  DENTAL    MEDICINE. 


prominent,  with  a  distinct  hollow  in  front  of  each  ear.  A 
single  dislocation  is  indicated  by  the  mouth  being  only 
partially  open,  the  chin  displaced  to  one  side,  the  distinct 
hollow  below  the  ear  being  on  the  opposite  side. 

Fracture  of  the  Lower  Jaw  is  indicated  by  inability  to  close 
the  mouth,  and  to  speak  articulately ;  laceration  of  the  gums 
and  hemorrhage ;  irregularity  of  the  teeth  from  displacement 
of  the  fragments  of  bone ;  crepitation.  Fracture  of  the  maxilla 
may,  however,  show  no  displacement,  or  the  fracture  extending 
through  the  angle  or  ramus  may  be  diagnosed  by  grasping  the 
two  sides  of  the  jaw  and  moving  them  forcibly.  Crepitus, 
increased  flow  of  saliva,  mobility  of  fragments,  and  irregularity 
of  the  teeth,  if  the  fracture  is  through  the  body  of  the  bone,  are 
all  signs  of  fracture.  A  swollen,  red  and  painful  condition  of 
the  tissues  covering  the  lower  jaw,  occurring  some  days  after 
the  accident,  denote  the  possibility  of  fracture,  neglect  causing 
a  high  degree  of  inflammation,  and  in  some  cases  even  necrosis 
of  the  bone. 

Cleft  Palate  is  indicated  by  a  fissure  extending  through  the 
soft  palate  alone,  or  through  both  soft  and  hard  palates,  and 
which  may  be  combined  with  single  or  double  hare-lip,  in 
which  case  the  intermaxillary  bones  are  frequently  displaced. 

Hare-Lip  is  indicated  by  a  congenital  fissure  of  the  upper 
lip,  and  may  be  single  or  double,  and  may  also  be  combined 
with  fissure  of  the  hard  and  soft  palates. 

Facial  Paralysis  is  indicated  by  distortion  of  the  face,  in 
which  the  mouth  is  drawn  to  one  side,  being  due  to  paralysis 
of  the  facial  nerve.  The  eye  may  also  remain  permanently 
open  on  the  affected  side,  the  saliva  escape  from  the  corner  of 
the  mouth,  and  the  food  collect  under  the  cheek,  on  account  of 
the  paralysis  of  the  buccinator  muscle. 

A  Nasal  Polypus  is  indicated  by  more  or  less  obstruction  of 
one  or  both  nostrils,  with  occasional  watery  discharge ;  a  gray 
or  yellowish  mass,  like  jelly  in  consistence,  can  be  detected  by 
the  finger,  if  it  is  passed  behind  the  soft  palate,  hanging  down 
into  the  pharynx,  and  which  greatly  increases  in  damp  weather; 
the  nose  bulged  out  on  one  side  by  the  growth  within. 


DIAGNOSIS   OF   MOUTH    AFFECTIONS.  19 

Thnisli  is  indicated  by  small  white  spots,  the  size  of  a  pin's 
head,  upon  the  dorsal  surface  of  the  tongue,  palate,  velum, 
inside  of  cheek  and  lips,  which  increase  in  size  and  coalesce, 
with  a  tendency  to  form  false  membrane,  the  crusts  falling  off 
and  reappearing ;  the  mucous  membrane  beneath  redder  than 
natural. 

AphtJicB  or  Follicular  Ulceration  is  indicated  by  the  mucous 
membrane  becoming  inflamed,  and  the  formation  of  small, 
round,  transparent  vesicles  on  the  frsenum  in  the  sulcus 
between  the  lips  and  gums  and  lower  surface  of  tongue.  On 
the  bursting  of  the  vesicles,  small,  spreading  ulcers,  with  red 
and  swollen  margins,  appear,  which  become  coated  with  a 
layer  of  oidium  albicans. 

Epulis  is  indicated  by  a  growth  on  the  gums,  either  small 
and  pedunculated,  or  large  and  sessile. 

Epitliclionia  is  indicated  by  a  ragged  ulcer  on  the  lower  lip, 
commencing  as  a  wart,  the  skin  around  being  hard  and 
infiltrated,  with  enlargement  of  the  submaxillary  lymphatic 
glands,  which  become  tender,  or  even  ulcerated. 

Hypertrophy  of  the  Gums  is  indicated  by  an  increase  of  their 
substance  to  such  a  degree  as  to  cause  them  to  overhang  and 
cover  the  greater  portion  of  the  crowns  of  the  teeth  ;  tendency 
to  hemorrhage ;  gums  dark  and  livid ;  fetor  of  breath  ;  increased 
flow  of  saliva. 

Rigg's  Disease,  or  Pyorrhoea  Alveolaris,  is  indicated  at  first 
by  an  uneasy  sensation ;  then  inflammation  of  margins  of 
gums;  recession  of  gums  and  absorption  of  alveolar  processes; 
a  tendency  to  hemorrhage ;  inflammation  extending  deeper 
into  gums ;  small  sulci  filled  with  pus  ;  looseness  of  the  teeth 
and  change  of  positions ;  disagreeable  taste ;  fetor  of  breath ; 
dark  livid  color  of  gums,  with  thick  margins ;  in  some  cases 
the  gums  denuded  of  their  epithelium,  with  a  polished  appear- 
ance ;  the  teeth,  at  length,  held  in  their  cavities  by  a  tough, 
ligamentous  attachment,  due  to  the  change  occurring  in  the 
periosteum. 

Irritation  of  the  Dental  Pulp  is  indicated  by  an  uneasy  sensa- 
tion, which  develops  into  pain  of  a  gnawing  or  boring  character. 


20  DENTAL    MEDICINE. 


the  affected  tooth  being  sensitive  to  changes  of  temperature, 
painful  in  mastication,  but  exhibiting  no  symptoms  of  inflam- 
mation of  the  gum  or  periosteum. 

Acute  Inflammation  of  the  Dental  Pulp  is  indicated  by  acute 
pain  in  the  affected  tooth,  which  frequently  extends  to  neigh- 
boring teeth  and  to  the  side  of  the  face,  but  is  more  intense  in 
the  tooth  itself;  pain  may  subside  after  a  few  hours'  duration, 
to  return  again  on  the  slightest  provocation,  or  on  patient 
assuming  a  horizontal  position ;  the  pain  may  also  assume  a 
throbbing  character. 

Chronic  Inflammatioii  of  tlie  Dental  Pulp  is  indicated  by  pain 
less  severe  than  in  the  acute  form,  and  of  less  duration  ;  coming 
on  at  irregular  intervals,  and  wandering,  like  neuralgic  pains, 
and  incited  by  changes  of  temperature,  and  the  application  of 
irritants. 

Ossification  of  the  Dental  Pulp  is  indicated  by  pain  of  a 
neuralgic  character,  which  commences  in  an  uneasy  feeling, 
and  changes  to  what  has  been  described  as  a  gnawing  sensa- 
tion, similar  to  that  which  attends  the  knitting  together  of  the 
fractured  parts  of  a  bone.  It  may  be  continuous,  but  not 
constantly  severe,  and  frequently  amounts  to  no  more  than  an 
uneasy  sensation  ;  at  other  times  it  may  be  sharp  and  darting, 
affecting  the  side  of  the  head,  and  all  the  branches  of  the  supe- 
rior maxillary  division  of  the  fifth  pair  of  nerves.  The  affected 
tooth  is  free  from  soreness  and  discoloration. 

Abnormal  Sensibility  of  Dentine  is  indicated  by  pain  resulting 
from  irritation  of  dentinal  structure,  being  of  shorter  duration 
and  less  acute  in  character  than  that  from  an  inflamed  dental 
pulp ;  the  pain  of  sensitive  dentine  soon  subsides  on  the 
removal  of  the  irritating  cause. 

Atrophy  of  the  Teeth  is  indicated  by  certain  structural  defects 
in  the  enamel,  in  the  form  of  opaque  spots  or  pits. 

Abrasion  of  the  Teeth  is  indicated  by  a  loss  of  structure,  due 
to  friction,  to  such  an  extent  at  times  as  to  destroy  the  entire 
crowns. 

Hypertrophy  of  the  Alveolar  Processes  is  indicated  by  an 
osseous  deposit,  either  at  the  apex  of  the  alveolar  cavity,  in 


DIAGNOSIS    OF    MOUTH    AFFECTIONS.  21 


which  case  the  affected  tooth  is  protruded  from  its  cavity,  or 
by  a  deposit  of  osseous  matter  on  the  wall  of  the  alveolar 
cavity,  in  which  case  the  tooth  is  forced  to  one  side. 

Dental  Exostosis  is  indicated  by  an  uneasy  sensation  in  the 
affected  tooth,  followed  by  a  gnawing  pain,  which  in  some 
cases  assumes  a  severe  neuralgic  character,  especially  when 
the  deposit  of  cementum  on  the,  root  is  of  considerable  size,  in 
which  case  there  is  a  prominence  apparent  on  the  side  of  the 
alveolar  ridge. 

Odontomes  are  indicated  by  irregular  masses  of  dental  tissues, 
which  result  from  morbid  conditions  of  the  formative  pulp, 
such  as  nodules  of  enamel  and  dentine,  hypertrophy  of 
cementum,  etc.,  some  being  congenital,  others  induced. 

Syphilitic  Teeth  are  indicated  by  notches,  generally  crescentic, 
in  the  cutting  edges  of  the  incisors,  and  peg-like  shaped 
cuspids  ;  also,  a  dark  color  and  soft  consistence  are  charac- 
teristic of  such  teeth. 

Denuding  of  the  Teeth  is  indicated  by  the  gradual  destruction 
of  the  enamel  of  the  labial  surfaces  of  the  incisors,  canines,  and 
sometimes  of  the  bicuspids,  generally  in  the  form  of  a  continu- 
ous horizontal  groove,  smooth  and  regular  ;  in  some  cases  it 
may  extend  over  nearly  the  whole  of  the  labial  surface,  the 
color  of  the  enamel  being  rarely  changed. 

Dental  Caries  is  indicated  by  a  process  of  gradual  softening 
and  disintegration  of  the  tooth  tissues  by  deleterious  agents, 
the  progress  being  hastened,  primarily,  by  certain  structural 
defects  in  the  enamel  and  dentine,  and  secondarily,  by  certain 
diseases  of  the  mucous  membrane,  and  some  derangement  of 
the  general  health.  Incipient  dental  caries  is  indicated  by  an 
opaque,  whitish  or  gray  appearance  of  the  enamel.  A  pale 
brown  varying  to  a  nearly  black  color  indicates  the  existence 
and  progress  of  dental  caries  in  the  tooth  tissues  ;  the  deeper 
the  color  the  slower  the  progress  of  the  caries,  and  the  paler 
the  color  the  more  rapid  the  progress. 


22 


DENTAL   MEDICINE. 


CHARACTERISTIC  INDICATIONS  OF  THE 
TONGUE. 

A  White  Coated  Tongue  indicates  febrile  disturbance. 

A  Brotun  Moist  Tongtte  indicates  digestive  disorder  and  an 
overloaded  stomach. 

A  Brown  Dry  Tongue  indicates  depressed  vital  power. 

A  Red  Moist  Tongue  indicates  feebleness,  especially  from 
exhaustive  discharges. 

A  Red  Dry  Tongue  indicates  inflammatory  fever  or  pyrexia. 

A  Red  Glazed  Tongue  indicates  debility  and  inability  to 
digest  food  and  stimulants. 

A  Trentidous,  Moist  and  Flabby  Tongue  indicates  feebleness 
and  nervousness. 

A  Glazed  Bluish  Tongue,  with  loss  of  epithelium  in  patches, 
and,  in  severe  cases,  cracks  and  scars,  indicates  tertiary  syphilis. 

ABBREVIATIONS. 
In  medical  prescriptions,  letters,  parts  of  words,  or  certain 
symbols,   are    employed   as    abbreviations,   to    designate   the 
substance,  quantity,  etc.,  as  follows : — 


ABBREVIATION. 

LATIN  WORD. 

ENGLISH  WORD. 

aa, 

Ana  (G.), 

Of  each. 

Ad  saturand., 

Ad  saturandum, 

Until  saturated. 

Ad  lib., 

Ad  hbitum, 

At  pleasure. 

Aq., 

Aqua, 

Water. 

Aq.  tepid, 

Aqua  tepida. 

Warm  water. 

Aq.  ferv., 

Aqua  fervens. 

Hot  water. 

Aq.  dest., 

Aqua  destillata. 

Distilled  water, 

C.  or  Cong., 

Congius, 

A  gallon. 

Chart, 

Chartula, 

A  small  paper. 

Coch., 

Cochlear, 

A  spoonful. 

Cocli.  mag., 

Cochlear  magnum. 

A  tablespoonful. 

Coch.  parv., 

Cochlear  parvum, 

A  teaspoonful. 

Colent., 

Colentur, 

Let  them  be  strained, 

CoUyr., 

Collyrium, 

An  eye-water. 

Comp., 

Compositus, 

Compound. 

Contus., 

Contusus, 

Bruised  or  broken. 

Cort., 

Cortex, 

Bark. 

Ext, 

Extractum, 

An  extract. 

ABBREVIATIONS. 

23 

ABBREVIATION. 

LATIN  WORD. 

ENGLISH  WORD. 

F.  or  Ft., 

Fiat  vel  fiant, 

Let  there  be  made. 

FoL, 

Folium  vel  folia, 

A  leaf  or  leaves. 

Garg., 

Gargarysma, 

A  gargle. 

Gr., 

Granum  vel  grana, 

A  grain  or  grains. 

Gtt., 

Gutta  vel  guttas. 

A  drop  or  drops. 

Haust., 

Haustus, 

A  draught. 

Infus., 

Infusum., 

An  infusion. 

M., 

Misce, 

Mix. 

Mass., 

Massa, 

A  mass. 

Mist., 

Mistura, 

A  mixture. 

0., 

Octarius, 

A  pint. 

PH., 

Pilula  vel  pilulas, 

A  pill  or  pills. 

Pulv., 

Pulvis  vel  pulveres, 

A  powder  or  powders. 

q.  s., 

Quantum  sufficit, 

A  sufficient  quantity. 

R, 

Recipe, 

Take. 

Rad., 

Radix, 

A  root. 

S., 

Signa, 

Write  or  give  directions. 

Spts., 

Spiritus, 

Spirits. 

ss., 

Semis, 

The  half. 

Syr., 

Syrupus, 

Syrup. 

Tinct, 

Tinctura, 

A  tincture. 

ft), 

Libra, 

A  pound. 

S> 

Uncia, 

An  ounce. 

5> 

Drachma, 

A  drachm. 

9. 

Scrupulus, 

A  scruple. 

f.?, 

Fluiduncia, 

A  fluid  ounce. 

fs, 

Fluidrachma, 

A  fluid  drachm. 

^, 

Minim, 

A  drop. 

Although  the  symbol  (rt\^)  is  adopted  in  the  United  States 
Pharmacopoeia  to  designate  a  drop,  it  should  be  remembered 
that  the  size  of  a  drop  varies  according  to  the  greater  or  less 
fluidity  and  gravity  of  the  liquid,  and  the  shape  of  the  mouth 
of  the  bottle  from  which  it  is  dropped.  It  is  best  to  use  a 
small  vial  with  a  thin  edge  of  mouth,  when  great  precision  is 
necessary,  and  to  dilute  the  active  medicine  and  administer  it 
in  the  form  of  a  mixture  ;  for  in  some  preparations,  one  hundred 
and  fifty  drops  would  measure  but  a  fluidrachm,  while  in  others 
the  same  number  of  drops  would  be  somewhat  more  than  three 
fluidrachms. 

A  tablespoonfid  of  any  liquid  is  regarded  as  equal  to  half  an 


24  DENTAL    MEDICINE. 


ounce  by  measure  ;  and  a  teaspoonful  equal  to  a  fliiidrachm  ; 
and  such  measures  are  sufficiently  accurate  where  no  great 
precision  is  requisite. 

A  gallon  contains  eight  pints. 

A  pint  contains  sixteen  fluidounces. 

A  fluidounce  contains  eight  fluidrachms. 

A  fluidrachm  contains  sixty  minims  (n\,). 

A  wine  glass  (approximate  measurement)  contains  two  fluid- 
ounces. 

A  teacup  (approximate  measurement)  contains  four  fluid- 
ounces. 

A  tablespoon  of  powder  (approximate  measurement)  contains 
two  drachms. 

A  teaspoon  of  powder  (approximate  measurement)  contains 
one-half  drachm. 

One  drop  of  water  (small  drop,  approximate  measurement) 
contains  one  minim. 

One  drop  of  essential  oils  (approximate  measurement)  con- 
tains one-half  minim. 

A  graduated  measure  glass  is  the  most  accurate  measure,  as 
spoons,  glasses,  etc.,  vary  greatly  in  size. 

FINENESS   OF  POWDER. 

The  fineness  of  powder  is  denoted  either  by  descriptive 
words  (as  in  the  case  of  brittle  or  easily  pulverizable  substances), 
or  in  terms  expressing  the  number  of  meshes  to  a  linear  inch 
in  the  sieve.  The  following  degrees  of  fineness  will  prove 
serviceable  in  the  preparation  of  dentifrices,  polishing  powders, 
etc. : — 

f  Should  pass  through  a^ 

A  very  fine  powder     .     .     \  sieve  having  so  or  more  \  =No.  80  Powder. 

•'•''■  y   meshes  to  linear  inch,    j 

(  Should  pass   through  a"j 

A  fine  powder      .     .     .     -^  sieve  having  60  meshes  v= No,  60  Powder. 

•'  -^  (.to  the  Hnear  inch.       j 

f  Should  pass  through  ^)         ^.y  -^ 

A  moderately  fine  powder^  sieve  having  50  meshes  v= No.  50  Powder. 

-^  ■*•  (.       'o  the  linear  inch.       J 

f  Should  pass  through  a"! 

A  moderately  coarse  powdery  sieve  having  40  meshes  l-=No.  40  Powder. 

■^  (.to  the  linear  inch.       J 

C  Should  pass   through  a"|  -i->  i 

A  coarse  powder   ,     .     .     -^  sieve  having  20  meshes  ^=No.  20  Powder. 

(,      to  the  linear  inch.       ) 


WEIGHTS    AND    MEASURES.  25 

WEIGHTS   AND   MEASURES. 

APOTHECARIES'  WEIGHT. 
20  grains  (gr.)  make  I  scruple sc.  or  ^ 

3  scruples        make  i  drachm dr.  or  z 

8  drachms       make  i  ounce oz.  or  5 

12  ounces  make  I  pound lb.  or  ft) 

SCALE   OF   COMPARISON. 

ft).                         OZ.                         dr.                          sc,  gr. 

I            =           12           =           96           =           288           =  5760 

I           =            8           =            24          =r  480 

1=3=  60 

I  =  20 

TROY   WEIGHT. 

24  grains  (gr.)      make  I  pennyweight dwt. 

20  pennyweights  make  i  ounce oz. 

12  ounces  make  i  pound  ft). 

3/^  grains  make  i  carat  (diamond  weight) k. 

SCALE   OF   COMPARISON. 

ft).  OZ.  dwt.  gr. 

I  =  12  :=  240  =  5760 

I  =  20  =  480 

I  =  24 

I  k.  =  y/^ 

AVOIRDUPOIS   WEIGHT. 

16  drachms  (dr.)    make  i  ounce oz, 

16  ounces  make  i  pound ft). 

25  pounds  make  1  quarter qr. 

4  quarters  make  i  hundredweight cwt. 

20  hundredweight  make  i  ton  T. 

100  pounds  make  i  cental C. 

SCALE   OF  COMPARISON. 

T.                cwt.                qr.                   ft).                     oz.  dr. 

I        =:       20       =       80       =       2000      =       32000  =  512000 

I        =         4       =         100      =         4000  =  25600 

I       =           25       ^=           400  =  6400 

I       =             16  7=  256 

I  =  16 

THE   METRIC   OR   FRENCH   DECIMAL   SYSTEM  OF  W^EIGHTS 
AND   MEASURES. 

The  metric  system  is  based  upon  the  meter,  which  is  the 
standard  unit  oi  length  of  that  system,  and  equal  to  39.370432. 
inches,  or  about  10  per  cent,  longer  than  the  yard, 
3 


26  DENTAL    MEDICINE. 


The  metric  unit  oi  fluid  measure  is  the  liter — the  cube  of 
To  meter,  or  lOOO  cubic-centimeters — equal  to  about  34  fluid 
ounces. 

The  metric  unit  of  weiglit  is  the  gram,  which  represents  the 
weight    of  one    cubic-centimeter    of  water   at    its    maximum 
density.     It  is  equal  to  I5(.43234874)  troy  grains. 
One  cubic-centimeter  is  equal  to  16.231  minims. 
In  writing  prescriptions  it  is  sufficiently  accurate  and 
safe  to  consider  i  gram  as  exactly  equal  to  i  5  troy  grains, 
and  to  consider  i  cubic-centimeter  as  equal  to  1 5  minims. 
We  accordingly  have  : — 

I  gram  equal  to  ij5  troy  grains. 
I  troy  grain  equal  to  J^  gram. 
I  cubic-centimeter  equal  to  \  fluid  drachm. 
I  fluid  drachm  equal  to  \  cubic-centimeter. 
Hence — 

1.  To  CONVERT  TROY  GRAINS  INTO  GRAMS,  OR  MINIMS  INTO 
CUBIC-CENTIMETERS 

a.  Divide  by  lo,  aiidfrom  the  quotieitt  subtract  one-third ;  or, 
b.  Divide  by  IS ,'  and 

2.  To  CONVERT  APOTHECARIES'  DRACHMS  INTO  GRAMS,  OR 
FLUIDRACHMS  INTO  CUBIC-CENTIMETERS,  multiply  by  /f.. 

In  writing  prescriptions  the  "  gram  "  (abbreviated  "  Gm.") 
and  "  cubic-centimeter,"  (abbreviated  "  C.C.,"  which  may  be 
called  "  fluigram,"  and  written  "  f  Gm  ")  only,  should  be  used. 

The  centigram,  which  is  a  very  convenient  unit  to  refer  to 
in  medicine  and  pharmacy,  is  used  in  books  and  in  speaking, 
but  not  in  writing  prescriptions. 

All  other  terms,  and  units,  and  prefixes,  used  in  the  metric 
system,  may  be  wholly  ignored  by  the  physician  and  the  phar- 
macist.* 

*  The  prefixes  are  simply  numerals,  as  follows : — ■ 

myria,  which  means  io,ooo.  deci,  which  means  o.  I. 

kilo,  "  "        ijOOO.  centi,     "  "       o.oi. 

hecto,         "  "  lOO.  ifiilli,     "  "       o.ooi. 

deka,         "  "  lo. 

and  are  quite  unnecessary  in  the  writing  of  prescriptions  (if  not  in  all  cases), 
English  numerals  being  more  convenient,  and  at  least  equally  explicit. 


WEIGHTS   AND  MEASURES.  27 


EXAMPLE   OF   A    METRIC    PRESCRIPTION. 

R.    Hydrarg.  chloricli.  corros 0125  Gm. 

Potassii  iodidi 10  00  Gm. 

Aquas 100  00  C.  C. 

Tinct.  cinch,  comp 100 loo  C.  C. 

Mix. 

The  use  of  a  decimal  line  prevents  possible  errors. 

To  write  a  prescription  for  fifteen  doses  of  any  medicine, 
write  it  first  for  one  dose  in  grains  and  vtinims,  and  then 
substitute  the  same  number  of  "  grams  "  and  "  cube-cents," 
thus : — 

R-    Opii gr.     j 

Camphorfe gr.    ij. 

Make  one  pill. 

and  to  get  fifteen  such  doses  in  metric  terms,  write — 

R.    Opii I  Gm. 

Camphora; 2  Gm. 

Make  fifteen  pills. 

The  gram  and  the  cubic-centimeter  {fluigravi),  when  referring 
to  liquids,  may  be  considered  as  equal  quantities,  except  the 
liquids  be  very  heavy  (as  in  the  case  of  chloroform),  or  very 
light  (as  in  the  case  of  ether). 

Measures  may  be  discarded  and  weights  exclusively  em- 
ployed, if  preferred.  All  quantities  in  a  prescription  would 
then  be  expressed  in  grams.* 

The  average  "  drop  "  (water)  may  be  considered  equal  to 
0.05  C.  C,  or  0.05  Gni.  An  average  teaspoon  holds  5  C.  C, 
and  an  average  tablespoon  20  C.  C.  Decimal  numbers  should 
be  used  as  far  as  practicable  without  sacrifice  of  accuracy  as 
to  strength  and  dose  of  the  preparation.  It  is  safe  to  prescribe 
30  Gm.  for  one  troy  ounce,  and  250  C.  C.  for  eight  fluid- 
ounces. 


*  As  any  liquid  medicine  must  necessarily  be  administered  to  the  patient  in 
measured,  and  not  in  wev^^hed,  doses,  it  will,  of  course,  be  more  convenient  to 
the  physician  to  continue  to  make  use  of  fluid  measures  in  writing  prescriptions, 
especially  as  he  is  already  accustomed  to  this,  and  would  not  then  have  to  bear 
in  mind  the  specific  gravity  of  any  liquid  ingredient  in  the  prescription.  To  the 
pharmacist  it  makes  but  little  difference,  as  he  will  have  both  weights  and  meas- 
ures, and  can  use  one  or  the  other,  as  may  be  directed.  If  the  physician  discards 
measures,  he  must,  of  necessity,  so  adjust  the  proportion  in  his  formula  as  to 
produce  a  mixture  of  which,  after  all,  the  dose  must  be  a  "  teaspoonful,"  or  some 

other  convenient  measure,  and  this  is  as  unnecessary  as  it  is  difficult. Oscar 

Oldberg,  Phar.  D.,  in  Blakiston'' s  Phys.  Visiting  List. 


28 


DENTAL    MEDICINE. 


The  above  contains  all  that  it  is  necessary  to  know  or 
LEARN  of  the  metric  system,  in  order  to  write  metric 
PRESCRIPTIONS,  without  a  metric  posological  table,  or  with 
one. 

To  become  familiar  with  the  system,  the  rules  given  above 
for  the  conversion  of  apothecaries'  weights  and  measures  into 
the  corresponding  metric  quantities,  may  be  profitably  used, 
the  results  to  be  verified  by  comparison  with  the  following 


TABLE   OF    EQUIVALENTS. 


apothecaries   weights 
(and  measures). 

Troy  grains  [or  minims). 

1 
1 


2 

5 

lO 

IS 

20 

3° 

Drachms  (or  fiuidrachms). 
I 

2 

4 


Troy  ounces  (or  fluidounces). 
I 
2 
4 

6 
8 

12 

i6 


METRIC 

:   WEIGHTS 

(and  measures). 

Grams  (or  cubic-ceniimeiers). 

O.OOI 

(toW) 

0.002 

(t/oit) 

0.004 

(tAt) 

0,008 

(x^Vcj-) 

0.016 

(^V) 

0.033 

(3V) 

0.066 

(tV) 

0-133 

(A) 

0.333 

(i) 

0.666 

(1) 

1. 000 

(I) 

^■2>32, 

(li) 

2.000 

(2) 

Grams  (or  cubic-centimeters) . 

4 

8 

16 

24 

32 

64 

128 

192 

256 

384 

512 


The  adoption  of  the  metric  system  of  weights  and  measures 
is  a  matter  of  time  only.  Its  advantages  over  other  systems 
are  well  recognized. 


RULES    FOR    REGULATING    DOSES. 


29 


RULES   FOR   REGULATING   DOSES. 

The  doses  given  in  this  work  are  apphcable  to  adult  age, 
unless  the  contrary  is  specified  ;  and  for  the  convenience  of 
students,  the  rules  of  Gaubins  and  Young  for  determining  the 
proper  doses  of  medicines  for  children  are  furnished  below. 

Take  the  dose  for  an  adult  as  unity,  and  for  other  ages  as 
follows : — 

The  dose  for  a  person  of  middle  age  being  i,  or  i  drachm, — 

That  for  a  person  from  14  to  21  years  will  be  5^,  or    2  scruples. 


a  child  of 


7  to  14 

4  to    7 

4 

3 


%,  ox  Yz  2.  drachm. 
Yi,  ox    I  scruple. 
X.  or  15  grains. 
Y(>,  ox  10  grains. 
Y%,ox    8  grains. 
tV.  or 


I  year         "      y^,  or    5  grams. 

The  following  simple  rule  by  Dr.  Young  will  be  found  to  be 

convenient :     "  For  children  under  twelve  years,  the  doses  of 

most  medicines  must  be  diminished  in  the  proportion  of  the 

age  to  the  age  increased  by  12  ;  thus,  at  two  years  to  \ ;  viz  : 


— ; —  =  — .     At   twenty-one 
2  +  127 

Hence, — 


the   full    dose    may    be   given." 


I 

I 

I  -j-  12 

13 

2 

I 

2+12 

7 

3 

I 

3  +  12 

5 

4 

I 

4+12 

4 

6 

I 

For  one  year, 

For  two  years, 

For  three  years, 

For  four  years. 

For  six  years, 

^  6+12        3 

At  twelve  years  the  dose  is  one-half  that  of  the  adult.  The 
U.  S.  Dispensatory  states  that  "  To  the  above  rules  some  excep- 
tions are  offered,  in  particular  medicines,  which  require  to  be 
given  to  children  in  much  larger  proportional  doses  than  those 
above  stated.  Such  are  castor  oil  and  calomel,  a  certain 
quantity  of  which  will,  in  general,  not  produce  a  greater  effect 
in  a  child  two  or  three  years  old  than  double  the  quantity  in 


30  DENTAL    MEDICINE. 


an  adult."  "  Females  usually  require  smaller  doses  than 
males,  and  persons  of  sanguine  temperament  than  the  phleg- 
matic." The  influence  of  constitutional  peculiarities,  such  as 
are  known  as  idiosyncrasies,  often  exist  and  render  patients 
more  than  usually  susceptible,  or  the  opposite,  to  the  action  of 
medicines,  the  doses  of  which  must  be  regulated  accordingly. 
It  should  also  be  remembered  that  the  susceptibility  to  the 
action  of  medicines  is  diminished  by  frequent  and  continued 
use.     In  advancing  age,  the  dose  is  gradually  lessened. 

Opiates  affect  children  to  a  greater  degree  than  adults,  but 
children  bear  larger  doses  of  calomel  than  adults.  Females 
are  more  rapidly  affected  by  purgatives  than  males,  and  the 
condition  of  the  uterine  system  is  very  important. 

Medicinal  substances  act  differently  on  the  same  person  in 
summer  and  in  winter,  and.  in  different  climates.  Narcotics 
act  more  energetically  in  hot  than  in  cold  climates,  and,  as  a 
consequence,  smaller  doses  are  required  in  hot  climates;  the 
opposite  is  the  case  with  regard  to  calomel.  Owing  to  a 
peculiarity  of  stomach,  or  rather  disposition  of  body,  uncon- 
nected with  temperament,  comparatively  mild  remedies  operate 
very  violently  on  some  individuals. 

When  administering  remedies,  the  intervals  between  the 
doses  should  be  so  regulated  that  the  second  dose  may  be 
taken  before  the  effect  produced  by  the  first  is  entirely  effaced. 
Some  medicinal  substances,  such  as  mercurial  salts,  arsenic, 
etc.,  are  prone  to  accumulate  in  the  system ;  and  dangerous 
symptoms  may  arise,  if  the  doses  rapidly  succeed  one  another. 

The  action  of  some  remedies,  such  as  digitalis,  elaterium, 
etc.,  may  continue  long  after  the  discontinuance  of  the  agent, 
and  a  too  powerful  effect  occur,  even  by  a  repetition  in  dimin- 
ished doses.  Some  remedies,  such  as  castor  oil,  aloes,  etc., 
acquire  activity  by  continued  use,  hence  the  dose  requires  to 
be  diminished. 


TABLE  OF  THE  DOSES  OF  MEDICINES. 

Arranged  in  Alphabetical  Order,  and  Expressed  in  Terms  of  Both  the  Apothecaries'  and  the 
Decimal  Metric  System  of  Weights  and  Measures. 

Revised  and  Corrected  according  to  the  New  Pharmacopoeial  Standard    (1883). 
BY   OSCAR   OLDBERG,   PH.D. 


Remedies. 


Abstract,  aconiti  .  . 
Abstract,  aspidospermae 
Abstract,  belladoniice 
Abstract,  cannab.  ind 
Abstract,  conii  .  . 
Abstract,  coto .  .  . 
Abstract,  digitalis 
Abstract,  gelsemii  . 
Abstract,  hyoscyami 
Abstract,  ignatiae 
Abstract,  ipecac  .  . 
Abstract,  jalapas  .  . 
Abstract,  nuc.  vom  . 
Abstract,  phytolaccaa 
Abstract,  pilocarpi  , 
Abstract,  podophylli 
Abstract,  sanguin.  alterat. 
Abstract,  sanguin.  emet.  . 
Abstract,  senegae.  .  .  . 
Abstract.  Valerianae .  .  . 
Abstract,  veratr.  vir.      .     . 

Acet.  lobelice 

Acet.  opii 

Acet.  sanguinar   .     .     .     . 

Acet.  scillae 

Acid.  acet.  dil 

Acid,  arsenios      .     .     .     . 

Acid,  benzoic 

Acid,  boric 

Acid,  carbolic 

Acid,  gallic 

Acid.  gall,  in  albuminuria 
Acid,  hydrobrom.  34% 
Acid,  hydrobrom.  dil 
Acid,  hydrochlor.  . 
Acid,  hydrochlor.  dil 
Acid,  hydrocyan.  dil 
Acid,  lactic  .  .  . 
Acid,  nitr    .... 


Dose  in  metric  weights 
or  measures. 


3  to  ID  centigrams. 
0.30  to  1.20  grams   . 

3  to  10  centigrams. 
6  to  20  centigrams. 
6  to  20  centigrams. 
6  to  20  centigrams. 
6  to  20  centigrams. 
6  to  20  centigrams. 

12  to  40  centigrams. 

6  to  20  centigrams. 
0.20  to  2  grams. 
0.40  to  2  grams. 

6  to  20  centigrams. 
0.30  to  I  gram    .     . 
0.40  to  2  grams   . 
25  to  60  centigrams. 

6  to  20  centigrams. 
0.60  to  1.20  Gm  .  . 
25  to  60  centigrams. 
0.60  to  1.20  Gm  . 

6  to  20  centigrams. 
I  to  4  C .  c     .     . 
0.30  to  I  C.  c  .     .     . 

I  to  2  C.  c  .  .  . 
0.60  to  2  C.  c.     .     . 

4  to  6  C.  c  .  .  . 
I  to  5  milligrams  . 

0.30  to  I  Gm  .     . 
30  to  60  centigrams. 

6  to  20  centigrams. 
0.20  to  I  Gm  .  .  . 
0.60  to  4  Gm  .  .  . 
0.60  to  I  Gm  .     .     . 

I  to  2.50  C.  c  .  . 
20  to  60  centigrams. 
0.60  to  2  C.  c  .  . 
o.io  to  0.30  C.  c  .     . 

I  to  4  Gm  .  .  . 
20  to  60  centigrams. 

31 


Dose  in  apothecaries' 
weights  or  measures. 


Yz  to 

i^  grains. 

=;to 

20  grams. 

Vi  to 

lyi  grains. 

I  to 

3  grams. 

I  to 

3  grams. 

I  to 

3  grams. 

I  to 

3  grams. 

I  to 

3  grams. 

2  to 

6  grains. 

I  to 

3  grains. 

3  to 

30  grams. 

6  to 

30  grams. 

I  to 

3  grams. 

Sto 

15  grains. 

6  to 

30  grains. 

4  to 

10  grains. 

I  to 

3  grams. 

10  to 

15  grams. 

4  to 

10  grains. 

10  to 

1 5  grains. 

I  to 

3  grams. 

1 5  to  60  minims. 

Sto 

16  minims. 

15  to 

30  minims. 

10  to 

30  minims. 

60  to 

90  minims. 

^Vto 

xV  grain. 

sto 

15  grams. 

Sto 

10  grains. 

I  to 

3  grains. 

3  to 

I  S  grains. 

10  to  60  grains. 

10  to 

1 5  grams. 

15  to 

40  minims. 

3  to 

10  grains. 

10  to 

30  minims. 

2  to 

6  minims. 

1 5  to  60  grains. 

3  to 

10  graiAs. 

32 


DENTAL    MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies. 


Acid.  nitr.  dil  .     .     . 
Acid,  nitro-hydrochlor 
Acid,  nitro-hydrochlor.  dil 
Acid,  phosphoric  (50%) 
Acid,  phosphoric  dil 
Acid,  salicyl    .     .     . 
Acid,  sulphuric    .     . 
Acid,  sulphuric  dil    . 
Acid,  sulphuric  arom 
Acid,  sulphuros    .     . 
Acid,  tannic     .     .     .. 
Aconitina   (white  crystals) 

Aloe 

Aloinum      .... 

Alumen 

Ammonii  benzoas     . 
Ammonii  bromid 
Ammonii  carb      .     . 
Ammonii  chlorid 
Ammonii  iodid     .     . 
Ammonii  phosph 
Ammonii  picras  .     . 
Ammonii  sulph    .     , 
Ammonii  valer     .     . 
Amyl  nitris      .     .     . 
Amylum  iodatum 
Ant.  et  pot.  tartr. ;  diaph 
Ant.  et  pot.  tartr. ;  emetic 
Antimonii  oxid     .     .     . 
Antimonii  oxysulphuret 
Antimonii  sulphid    . 
Antimonii  sulphuret 
Apomorph.  hydrochlor, 
Aqua  ammonias  .     . 
Aqua  amygd.  amor 
Aqua  camphorse  .     . 
Aqua  chlori.    .     .     . 
Aqua  creasoti .     .     . 
Aqua  laurocerasi 
Argenti  iodidum  .     . 
Argenti  nitras .     .     . 
Argenti  oxid    .     .     . 
Arsenii  iodidum  .     . 
Asafoetida    .... 
Atropina      .... 
Atropinse  sulph    .     . 
Auri  et  sodii  chlorid 
Bebeerin^  sulph  .     . 
Berberina  and  its  salts 
Bismuthi  citras     .     . 


Dose  in  metric  weights 
or  measures. 


0.60  to  2  C.  C      . 

20  to  60  centigrams 
0.30  to  1.30  C.  c 
0.20  to  I  Gm  .     . 
0.60  to  4  C.  c 
0.30  to  I  Gm  . 
0.30  to  0.60  Gm 
0.30  to  2  C.  c 
0.30  to  2  C.  c 

2  to  4  C.  c     .     . 
10  to  60  centigrams 
0.15  to  0.30  miligr 
10  to  30  centigrams 

6  to  20  centigrams 
0.50  to  I  Gm  . 
0.50  to  1.30  Gm  . 
0.30  to  2  Gm  .     . 
20  to  60  centigrams 

I  to  2  Gm     .     . 
0.20  to  I  Gm  .     . 
30  to  1.30  Gm 
0.50  to  3  centig'ms 
0.20  to  I  Gm  .     . 
0.20  to  I  Gm  .     . 
o.io  to  0.40  C.  c 
0.20  to  2  Gm  .     . 

4  to  10  milligrams 

6  to  10  centigrams 

3  to  10  centigrams 
3  to  10  centigrams 
3  to  10  centigrams 
3  to  10  centigrams 

3  to  6  milligrams 
0.30  to  2  C.  c. 
10  to  15  C.  c  . 
15  to  60  C.  c  . 

4  to  15  C. c  . 
4  to  15  C.  c  . 

0.30  to  2  C.  c 
3  to  10  centigrams 
I  to  2  centigrams 
3  to  10  centigrams 

1  to  2.50  milligr'ms 
0.30  to  1.30  Gm  .  . 
0.50  to  2  milligrams 
0.50  to  2  milligrams 

2  to  4  milligrams  . 
20  to  60  centigrams. 
0.20  to  I  Gm  .  .  . 
0.20  to  I  Gm  .     .     . 


Dose  in  apothecaries' 
weights  or  measures. 


10 

3 

5 

3 

10 

5 
5 
5 
5 
30 
2 
1 

2 

I 

10 

10 

5 
3 

15 
3 
5 

X 
3 
3 
2 

3 
1 

TB" 
I 


I 
I 

6 

*to 


o  30  mmims. 
o  10  grains. 
0  20  minims, 
o  15  grains, 
o  60  minims. 
015  grains, 
o  10  grains, 
o  30  minims, 
o  30  minims. 
o  60  minims, 
o  10  grains, 
to  2^0  grain, 
o    5  grains, 
o    3  grains. 
015  grains, 
o  20  grains, 
o  30  grains. 
0  10  grains. 
0  30  gi'ains, 
o  15  grains. 
o  20  grains, 
o  }4  grain. 
015  grains. 
015  grains, 
o    5  minims, 
o  30  grains, 
o  I  grain, 
o    2  grains, 
to  2  grains. 
0    2  grains. 
o    2  grains. 
o    2  grains, 
o  j\  grain, 
o  30  minims, 
o    4  fl.  drachms, 
o    2  fl.  oz. 
o    4  fl.  drachms, 
o    4  fl.  drachms, 
o  30  minims, 
o    2  grains, 
i  grain. _ 
o    2  grains, 
o  i-L  grain, 
o  20  grains, 
to  J 2  grain, 
to  3V  grain, 
o  tV  grain, 
o  10  grains. 
015  grains. 
o  15  grains. 


POSOLOGICAL   TABLES. 


33 


DOSE  TABLE  CONTINUED. 


Bismuthi  et  ammon.  citr  , 
Bismuthi  subcarb      .     . 
Bismuthi  subnitr .     .     .     . 
Bismuthi  tannas  .     •     .     . 
Bismuthi  valer     .     .     .     . 

Brayera  

Bromum 

Brucina 

Caffeina 

Cafifeinae  citras  .  .  .  . 
Calcii  bromidum .     .     .     . 

Calcii  carb 

Calcii  hypophosphis  .  . 
Calcii  iodidum  .  .  .  . 
Calcii  phosphas  .  .  .  . 
Calx  sulphurata    .     .     .     . 

Cambogium 

Camphora 

Camph.  monobrom  .     .     . 

Cantharis 

Capsicum 

Castoreum 

Catechu 

Cerii  nitras 

Cerii  oxalas     .   ~ .     .     . 

Chinoidinum 

Chloral 

Chloroformum  .  .  .  . 
Chrysarobinum    .     .     .     . 

Cinchona    

Cinchonidina,  and  its  salts 
Cinchonina,  and  its  salts  . 
Cinnamomum      .     .     .     . 

Codeina 

Confectio  sennge  .  .  .  . 
Coniina,  and  its  salts    .     . 

Copaiba 

Cotoina 

Creasotum 

Creta  praepar 

Croton  chloral      .     .     .     , 

Cubeba  

Cupri  acetas 

Cupri  sulphas 

Cuprum  ammon  .     ,     .     . 

Curare 

Curarina 

Decoct,  aloes  comp  .     .     . 
Decoct,  sarsap.  comp    . 
Digitalinum 


Dose  in  metric  weights 
or  measures. 


O.IO  to  I  Gm  .      . 

0.40  to  2  Gm  .     . 

0.40  to  2  Gm  .     . 

0.40  to  2  Gm  .     , 
6  to  20  centigrams 
8  to  1 5  Gm   .     . 
3  to  10  centigrams 
I  to  4  milligrams 
6  to  30  centigrams 
6  to  30  centigrams 

0.30  to  2  Gm  .     . 
I  to  4  Gm     .     . 

0.20  to  I  Gm  .     . 
6  to  20  centigrams 

1  to  2  Gm     .     . 

2  to  6  centigrams. 
6  to  25  centigrams 

20  to  60  centigrams 
10  to  30  centigrams 

3  to    6  centigrams 
6  to  20  centigrams 

0.40  to  I  Gm  .     . 

I  to  2  Gm     ,     . 

6  to  20  centigrams 

6  to  20  centigrams 
0.20  to  2  Gm  .     . 
0.20  to  I  Gm  .     . 
0.05  to  0.30  C.  c 
0.20  to  I  Gm  .     . 

I  to  4  Gm  .  . 
0.06  to  2  Gm  ,  . 
0.06  to  2  Gm  .  . 
0.40  to  2  Gm  .     . 

3  to  10  centigrams 

4  to  10  grams    . 

I  to  2  milligrams 
I  to  4  C.  c     .     . 
I  to  3  centigrams 
0.05  to  0.20  C.  c 
I  to  5  Gm     .     . 

5  to  60  centigrams 
I  to  4  Gm     .     . 

3  to  40  centigrams 
3  to  60  centigrams 

1  to    6  centigrams 

2  to  10  milligrams 
I  to    3  milligrams 

15  to  60  C.  c  .     . 
50  to  200  C.  c 
I  to  2  milligrams 


Dose  in  apothecaries' 
weights  or  measures. 


I  to  15  grains. 
6  to  30  grains. 
6  to  30  grains. 
6  to  30  grains. 

1  to    3  grains. 

2  to    6  drachms. 
^  to    2  grains. 
zh  to  j\  grain. 

I  to  5  grains. 
I  to    5  grains. 

5  to  30  grains. 
15  to  60  grains. 

3  to  15  grains. 
I  to    3  grains. 

15  to  30  grains. 
^  to    I  grain. 

1  to  4  grains. 
3  to  10  grains. 

2  to  5  grains. 
}i  to    2  grains. 

I  to    3  grains. 

6  to  15  grains. 
15  to  30  grains. 

I  to  3  grains. 
I  to    3  grains. 

3  to  30  grains. 
3  to  15  grains. 

I  to    5  minims. 

3  to  1 5  grains. 
1 5  to  60  grains. 

I  to  30  grains. 

I  to  30  grains. 

6  to  30  grains. 
}i  to    2.  grains. 

I  to    2  grains. 
6¥  to  A  grain. 
15  to  60  minims, 
i  to  i  grain.  _ 

I  to    3  minims. 
15  to  75  grains. 

1  to  10  grains. 
15  to  60  grains. 
^  to  6  grains. 
yi  to  10  grains. 
\  to  I  grain. 

-h  to  i  grain. 
^V  to  2V  grain. 
>i  to  2  fl.  ozs. 

2  to  6  fl.  ozs. 
-i^  to  -i^  grain. 


34 


DENTAL    MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies. 


Digitalis 

Duboisina,  and  its  salts  . 
Elaterinum;  U.S.  P.,  1880 
Elaterium;  U.  S.  P.,  1870 
Emetina,  and  salts,  emetic 
Emetina,  and  salts.,  diaph 
Emulsio  hydrocyan 

Ergota 

Ergotinum     .... 
Eserina  and  its  salts     . 
Extr.  absinthii      .     .     . 
Extr.  absinthii  fluid 
Extr.  achillege     .      .     . 
Extr.  achille£e  fluid 
Extr.  aconiti  fol.  (Engl). 
Extr.  aconiti  fol.;  U.  s.  P.,  70 
Extr.  aconiti  fol.  fluid    .     . 
Extr.  aconiti  rad.;  u.  S.  P.80 
Extr.  aconiti  [rad.J  fluid 
Extr.  aletridis  fl.       .     . 
Extr.  alni  rubrae  fl    .     . 
Extr.  aloes  aquos      .     . 
Extr.  alston,  constr.  fl. 
Extr.  angusturse  fl. 
Extr.  angelicae  rad.  fl. 
Extr.  anthemidis     .     . 
Extr.  anthemidis  fl.     . 
Extr.  apocyni  andros  fl. 
Extr.  apocyni  cannab.  fl 
Extr.  araliae  hisp.  fl.     . 
Extr.  aralise  nudic.  fl.  . 
Extr.  araliee  racem.  fl. 
Extr.  aralis  spin.  fl. 
Extr.  arecse  fl.      .     .     . 
Extr.  arnicse  flor.     .     . 
Extr.  arnicas  fl.     .     .     . 
Extr.  arnicse  rad.      .     . 
Extr.  arnica  rad.  fl. 
Extr.  aromat.  fl.  .     .     . 
Extr.  ari  triphylli  fl. 
Extr.  asari  fl.      .      .     . 
Extr.  asclep.  incarn.  fl. 
Extr.  asclep.  syr.  fl. 
Extr.  asclep.  tuber,  fl.  . 
Extr.  aspidii  fl.     .     .     . 
Extr.  aspidospermse  fl. 
Extr.  aurantii  cort.  fl.    . 
Extr.  azedarach  fl.    .     . 
Extr.  baptisise  fl. 
Extr.  bellad.  fol  (Eng.) 


Dose  in  metric  weights 
or  measures. 


3  to  10  centigrams. 
0.50  to  I  milligram. 

1  to    4  milligrams. 

4  to  30  milligrams. 
8  to  15  milligrams. 

0.50  to  2  milligrams. 

2  to  4  C.  c.  .  . 
I  to    4  Gm.  .     .     . 

10  to  50  centigrams. 

I  to  3  milligrams. 
10  to  60  centigrams. 

I  to  2  C.  c.  .  . 
20  to  60  centigrams. 

1  to    4  C.  c.      .     . 

2  to    6  centigrams. 

3  to  12  centigrams. 
0.05  to  0.30  C.  c.    . 

5  to  15  milligrams. 
0.03  to  0.15  C.  c.  . 
I  to  2  C.  c.  .  . 
I  to    2  C.  c.      .     . 

3  to  20  centigrams. 

4  to  15  C.  c.      .     . 

1  to    3  C.  c.      .     . 

2  to  4  C.  c.  .  . 
10  to  60  centigrams. 

2  to  4  C.  c.  .  . 
0.50  to  2  C.  c.  .  . 
0.50  to  2  C.  c.  .  . 
2  to  4  C.  c.  .  . 
2  to  4  C.  c.  .  . 
2  to   4  C.  c.      .     . 

2  to    4  C.  c.      .     . 

3  to  5  C.  c.  .  . 
20  to  50  centigrams. 

0.30  to  I  C.  c.  .  . 
10  to  30  centigrams. 
0.30  to  I  C.  c.  .  . 
2  to  4  C.  c.  .  . 
I  to  2  C.  c.  .  . 
I  to  2  C.  c.  .  . 
I  to  2  C.  c.  .  , 
I  to  2  C.  c.  .  . 
I  to  2  C.  c.  .  . 
5  to  15  C.  c.  .  . 
I  to  3  C.  c.  .  . 
I  to  10  Co.  .  . 
I  to  5  C.  c.  .  , 
o.5o_to  2  C.  c.  .  , 
I  to'  4 centigrams. 


Dose  in  apothecaries' 
weights  or  measures. 


^  to    2  grains. 
ih  to  eV  grain. 
eV  to  xV  grain. 
tV  to  'A  grain. 
y^to  X  gram, 
rh  to  -io  grain. 
^  to  I  fl.  drachm. 
1 5  to  60  grains. 
2  to    6  grains. 
■s\  to  ^V  grain. 

2  to    6  grains. 
15  to  30  minims. 

3  to  10  grains. 
15  to  60  minims. 
y  to    I  grain. 
^  to    2  grains. 

I  to    5  minims. 
-^j  to  X  grain. 
}4  to  2}4  minims. 
15  to  30  minims. 
15  to  30  minims. 
^  to    3  grains. 

1  to    4  fl.  drachms. 
1 5  to  45  minims. 

30  to  60  minims. 

2  to  10  grains. 
30  to  60  minims. 

8  to  50  minims. 

8  to  30  minims. 
30  to  60  minims. 
30  to  60  minims. 
30  to  60  minims. 
30  to  60  minims. 
45  to  75  minims. 

3  to    8  grains. 

5  to  15  minims. 

2  to    5  grains. 

5  to  15  minims. 
30  to  60  minims. 
15  to  30  minims. 
1 5  to  30  minims. 
15  to  30  minims. 
15  to  30  minims. 
15  to  30  minims. 

I  to    4  fl.  drachms. 
1 5  to  45  minims. 
X  to  2)4  fl.  drachms. 
15  to  75  minims. 

7  to  30  minims. 
ye  to  2/2.  grain. 


POSOLOGICAL  TABLE. 


35 


DOSE  TABLE  CONTINUED. 


Remedies. 


Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
E.xtr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 
Extr. 


bellad.  alcohol 
bellad.  fol.  fl. 
bellad.  rad.     . 
bellad.  rad.  fl. 
berber.  aquifol.  fl 
berber.  vulg.  fl. 
boldifl.  .     .     . 
brayerse  fl. 
bryonia;  fl. 
buchu  fl. 
calami  fl. 
calend.fl. 
calumbse 
calumbs  fl 
canellae  fl. 
cannab.  Amer.  f 
cannab.  ind.    . 
cannab.  ind  fl. 
cantharidis  fl. 
capsici  fl.     . 
cardam  comp.  fl 
cardui  bened.  fl. 


carnis  .  .  . 
cascarillae  fl.  . 
castanese  fl. 
catarice  fl.  . 
catechu  liquid 
caulophylli  fl. 
chelidonii  fl.  . 
chelonis  fl. 
chimaph.  fl. 
chionanthi  fl. 
chiratse  fl.  .  . 
cimicifugse  fl. 
cinchonffi  .  . 
cinchonse  fl.  , 
cinchonEe  arom.  fl, 
cinchon£E  comp.  fl 
cocculi  fl.  .  . 
colch.  rad. 
colch.  rad.  fl. 
colch.  sem.  fl. 
collinsoniae  fl. 
colocynth  . 
colocynth  comp 
condurango  . 
conii  fol.  (Engl.^ 
conii  fol. ale;  U.S. P.  70 
con  [fr.Jalc;  U.S. P. 80 
conii  fol.  fl       .     .     . 


Dose  in  metric  weights 
or  measures. 


I  to    3  centigrams 
0.20  to  0.40  C.  c. 
8  to  15  milligrams 
o.io  to  0.20  C.  c. 
I  to    2  C.  c. 
I  to    2  C.  c.       . 
0.20  to  I  C.  c.   . 
8  to  15  C.  c. 

1  to    4  C.  c. 

2  to  10  C.  c. 
I  to  4  C.  c. 
I  to    4  C.  c. 

20  to  60  centigrams 
I  to    4  C.  c. 
I  to    4  C.  c. 
0.20  to  I  C.  c.   . 
I  to    3  centigrams 
0.20  to  0.40  C.  c. 
0.06  to  0.20  C.  c. 
0.6  to  0.20  C.  c 
I  to    3  C.  c. 
I  to    4  C.  c. 
I  to    4  Gm. 

3  to  10  C.  c. 
3  to  10  C.  c. 
I  to    5  C.  c. 
0.50  to  2  C.  c. 
I  to    2  C.  c. 

1  to    2  C.  c. 

2  to    4  C.  c. 

3  to  5  C.  c. 
3  to  10  C.  c. 
2  to  5  C.  c. 
0.50  to  2  C.  c. 

1  to    2  Gm. 

2  to    4  C.  c. 
2  to    4  C.  c. 
2  to    5  C.  c. 
0.05  to  0.20  C.  c. 
2  to  10  centigrams 
0.20  to  I  C.  c.    . 
0.10  to  0.60  C.  c. 

2  to  4  C.  c. 
10  to  30  centigrams 
10  to  30  centigrams 
0.50  to  2  C.  c.  . 
5  to  20  centigrams 
5  to  10  centigrams 
2  to  6  centigrams 
0.20  to  I  C.  c.   . 


Dose  ill  apothecaries' 
weights  or  measures. 


yito)4  grain. 
3  to    6  minims, 
i^  to  X  grain. 

1  to  3  minims. 
15  to  30  minims. 
15  to  30  minims. 

3  to  IS  minims. 

2  to    4  fl.  drachms. 
15  to  60  minims. 

}4.  to  2)4  fl.  drachms. 
15  to  60  minims. 
15  to  60  minims. 

3  to  10  grains. 
15  to  60  minims. 
15  to  60  minims. 

3  to  15  minims. 
Yeto  yi  grain. 

3  to    6  minims. 

I  to    3  minims. 

I  to    3  minims. 
15  to  45  minims. 
15  to  60  minims. 
15  to  60  grains. 
34:"  to  2^  fl.  drachms. 
}(  to  2%  fl.  drachms. 
X  to  i^  fl.  drachms. 

8  to  30  minims. 
15  to  30  minims. 
15  to  30  minims. 
30  to  60  minims. 
X  to  iX  fl-  drachms. 
X  to  2%  fl.  drachms. 
X  to  iX  fl-  drachms. 

8  to  30  minims. 
15  to  30  grains. 
30  to  60  minims. 
30  to  60  minims. 
%  to  iX  fl-  drachms. 

I  to  3  minims. 
>^  to  i>^  grains. 

3  to  15  minims. 

I  ^  to  10  minims. 
30  to  60  minims. 

I>^  to  5  grains. 

iX  to  5  grains. 

8  to  30  minims. 

I  to    4  grains. 

I  to  1)4.  grains. 
Y  to  I  grain. 

3  to  15  minims. 


36 


DENTAL    MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies. 


Extr.  con.  [fr.]  fl. ;  U.S.  P.  80 
Extr.  convallariae  rad.  fl. 
Extr.  coptidis  fl.  . 
Extr.  corn.  flor.  fl. 
Extr.  corydalis  fl. 
Extr.  coto  fl.     .     . 
Extr.  cubebae  fl.  . 
Extr.  cypripedii  fl. 
Extr.  damianse  fl. 
Extr.  delphinii  fl. 
Extr.  digitalis 
Extr.  digitalis  fl. 
Extr.  dioscorese  fl. 
Extr.  ditae  fl.    .     . 
Extr.  dracontii  fl. 
Extr.  droserae  fl. 
Extr.  dulcamarse 
Extr.  dulcamarae  fl. 
Extr.  ergotas    .     . 
Extr.  ergotae  fl.     . 
Extr.  eryodictyi  fl. 
Extr.  erythroxyli  fl. 
Extr.  eucalypti  fl. 
Extr.  euonymi  fl. 
Extr.  eupatorii  fl. 
Extr.  euphorb.  ipec.  fl. 
Extr.  ferri  pom.    . 
Extr.  frangulae  fl. 
Extr.  frankeniae  fl 
Extr.  gallae  fl. 
Extr.  gelsemii 
Extr.  gelsemii  fl. 
Extr.  gent.  fl. 
Extr.  gent.  comp.  fl. 
Extr.  gent,  quinquefl.  fl 
Extr.  geranii  fl.    . 
Extr.  gei  fl.      .     . 
Extr.  gillenias  fl. 
Extr.  gossypii  fl. 
Extr.  granati  rad.  cort 
Extr.  grind,  rob.  fl. 
Extr.  grind,  squarr.  fl. 
Extr.  guaiaci  ligni  fl. 
Extr.  guaranae  fl. 
Extr.  haemotoxyli 
Extr.  haemotoxyli  fl. 
Extr.  hamamelid.  fl. 
Extr.  helleb.  nigris. 
Extr.  helleb.  nigris  fl. 
Extr.  heloniae  fl.  .     . 


Dose  in  metric  weights 
or  measures. 


o.io  to  0.30  C.  c 

1  to  2  C.  C. 

2  to  4  C.  C. 
2  to  4  C.  C. 
I  to  2  C.  C. 

0.20  to  I  C.  c 

I  to      2  C.  C, 

1  to    4  C.  c. 

2  to   10  C.  C. 

0.06  to  0.20  C.  c. 
I  to    3  centigrams 
0.10  to  0.40  C.  c. 

1  to  2  Gm. 
5  to  15  C.  c. 

2  to    4  C.  c. 
0.30  to  0.60  C.  c. 
0.30  to  I  Gm.    . 
4  to    8  C.  c. 

10  to  50  centigrams 
I  to    4  C.  c. 

1  to    2  C.  c. 

2  to  8  C.  c. 
I  to    4  C.  c. 

1  to    4  C.  c. 

2  to    4  C.  c. 
0.30  to  2  C.  c.   . 
0.20  to  I  Gm.     . 

2  to    10  C.  c.     , 
0.50  to  I  C.  c.   . 

3  to    8  C.  c.      . 
0.10  to  0.50  C.  c. 
0.10  to  0.50  C.  c. 
2  to    4  C.  c. 


Dose  in   apotliecaries' 
weights  or  measures. 


2  to 
I  to 
I  to 
I  to 
I  to 
I  to 

3  to 


c. 
c. 
c. 
c. 
c. 
c. 
c. 


4C 

2C. 
2  C. 
2  C. 
2  C. 
3C. 

8  C 
2  to  4  C.  c. 
2  to  4  C.  c. 
2  to    4  C.  c. 

1  to    2  C.  c. 
0.50  to  2  Gm.    . 

2  to    4  C.  c. 

2  to  6  C.  c.    .     . 

3  to  20  centigrams 
0.30  to  I  C.  c.   . 
0.50  to  2  C.  c.    . 


i^  to  5  minims. 
15  to  30  minims. 
30  to  60  minims. 
30  to  60  minims. 
15  to  30  minims. 

3  to  15  minims. 
15  to  30  minims. 
15  to  60  minims. 
Yz  to    lYz  fl.  drachms. 

I  to  3  minims. 
YdX-O  Yz  grain. 

I  to  6  minims. 
15  to  30  minims. 

I  to    4  fl.  drachms, 
30  to  60  grains. 

5  to  10  minims. 

5  to  15  grains. 

1  to    2  fl.  drachms, 
i/^  to  8  grains. 

15  to  60  minims. 
15  to  30  minims. 
^  to  2  fl.  drachms. 
15  to  60  minims. 
15  to  60  minims. 
30  to  60  minims. 

5  to  30  minims. 

3  to  15  grains. 
Yi  to  2Y2.  fl.  drachms. 

8  to  15  minims. 
^  to    2  fl.  drachms. 

2  to    8  minims. 
I  to    8  minims. 

30  to  60  minims. 
30  to  60  minims. 
15  to  30  minims. 
15  to  30  minims. 
15  to  30  minims. 
15  to  30  minims. 
15  to  45  minims. 
^  to  2  fl  drachms. 
30  to  60  minims. 
30  to  60  minims. 
30  to  60  minims. 
15  to  30  minims. 

8  to  30  grains. 
30  to  60  minims. 
30  to  90  minims, 
j^  to    3  grains. 

5  to  15  minims. 

8  to  30  minims. 


POSOLOGICAL   TABLES. 


37 


DOSE  TABLE  CONTINUED. 


Remedies. 


Extr.  hepaticse  fl.      .     . 
Extr.  humuli    .... 
Extr.  humuli  fl.    .     .     , 
Extr.  hydrangese  fl. 
Extr.  hydrastis     .     .     . 
Extr.  hydrastis  fl.       .     . 
Extr.  hyoscyami  (Engl.) 
Extr.  hyoscyami  ale.     . 
Extr.  hyoscyami  fol.  fl. 
Extr.  hyoscyami  sem.  fl. 
Extr.  ignatise  .... 
Extr.  ignatis  fl.    .     .     , 
Extr.  ipecac  fl.      .     .     . 
Extr.  iridis  versicol. 
Extr.  irid.  versicol.  fl. 
Extr.  jalapas;  U.S. P.,  1870 
Extr.  jalap;£  ale. 
Extr.  jalapEe  fl.    . 
Extr.  juglandis     . 
Extr.  juglandis  fl. 
Extr.  junip.  fl. 
Extr.  kamali  fl.    . 
Extr.  kino,  liquid 
Extr.  krameri^e     . 
Extr.  kramerige  fl. 
Extr.  laetucae  .     , 
Extr.  laetucae  fl.  . 
E.xtr.  lactucarii  fl. 
Extr.  lapps  fl. 
Extr.  larieis  fl. 
Extr.  leonuri  fl.    . 
Extr.  leptandrse. 
Extr.  leptandras  fl. 
Extr.  lobelise  fl.    . 
Extr.  lobeliae  sem.  fl 
Extr.  lupulini  fl.  . 
Extr.  lycopi  fl. 
Extr.  malti       .     . 
Extr.  manzanitae  fl. 
Extr.  marrubii  fl. 
Extr.  matico  fl.     . 
Extr.  matricariae  fl. 
Extr.  menispermi  fl. 
Extr.  methystice  fl. 
Extr.  mezerei  . 
Extr.  mezerei  fl.   . 
Extr.  micromeriae  fl 
Extr.  mitchellte  fl. 
Extr.  myriese  fl.   . 
Extr.  nectandrae  fl. 


Dose  in  metric  weights 
or  measures. 


2  to     4 

0.20  to 

2  to  4 
2  to     4 

20  to  60 
0.50  to 
5  to  25 
5  to  10 
0.20  to 
o.io  to 

2  to  8 
0.05  to 
0.20  to 
0.20  to 
I  to    2 

30  to  60 

20  to  40 

I  to    4 

1  to    2 

3  to    8 

2  to  4 
2  to    4 

1  to  2 
0.30  to 

2  to  4 
0.30  to 

1  to  4 
0.50  to 

4  to    8 

2  to  8 
2  to    4 

20  to  60 
2  to  4 
0.30  to 
0.20  to 
0.30  to 
0.30  to 

5  to  10 
2  to  8 
4  to  8 
2  to  4 
0.50  to 

2  to  4 
I  to    4 

3  to  6 
0.20  to 

1  to    4 

2  to  4 
2  to    4 

4  to  15 


C.  c.      . 

1  Gm.  . 
C.  e.  . 
C.  c.  . 
centigrams 

2  C.  e.   . 
centigrams 
centigrams 
I  C.  c.   . 
0.50  C.  e. 
centigrams 
0.30  C.  c. 
4  C.  c.   . 
0.30  Gm. 
C.  e.       . 
centigrams 
centigrams 
C.  c.       . 
Gm. 

C.  c.  . 
C.  c.  . 
C.  c.  . 
C.c.       . 

1  Gm.  . 
C.  e.      . 

I  Gm. 
C.  c.       . 

2  C.  e.  . 
C.  c.  . 
C.  c.  . 
C.c.  . 
centigrams 
C.c.       . 

2  C.  c.  . 
I  C.  c.  . 

1  C.  c.  . 

2  C.  c.  . 
Gm.  .  , 
C.  c.  . 
C.  c.  . 
C.  c.  . 
2  C.  e.  . 
C.  c.  . 
C.  c.  . 
centigrams 
0.60  C.  e. 
C.c.  . 
C.  c.  . 
C.  c.  . 
C.  c,      . 


Dose  in  apothecaries' 
weights  or  measures. 


60  minims. 
15  grains. 
60  minims. 
60  minims. 
10  grains. 
30  minims. 

4  grains. 

2  grains. 
15  minims. 

8  minims. 
iX  grains. 

6  minims, 
60  minims. 

6  grains. 
30  minims. 
10  grains. 

6  grains, 
60  minims, 
30  grains, 

2  fl.  drachms. 
60  minims. 
60  minims. 
30  minims. 
15  grains. 
60  minims. 
15  grains. 
60  minims. 
30  minims, 

2  fl.  drachms. 

2  fl.  drachms. 
60  minims, 
10  grains. 
60  minims. 
30  C.  c. 
15  C.  c. 
15  minims. 
30  minims. 

2^  drachms. 

2  fl.  drachms. 

2  fl.  drachms. 
60  minims. 
30  minims. 
60  minims, 
60  minims, 

I  grain. 
10  minims, 
60  minims, 
60  minims, 
60  minims, 

4  fl.  drachms. 


38 


DENTAL   MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies. 


fl. 


Exti".  nuc.  vom 

Extr.  nuc.  vom 

Extr.  nuphar  fl.    . 

Extr.  nymphsa  fl. 

Extr.  oenotherae  fl. 

Extr.  opii    .     .     " 

Extr.  papaveris    . 

Extr.  papaveris  fl. 

Extr.  pareirae  fl.  . 

Extr.  petroselini  fl. 

Extr.  phellandrii  fl. 

Extr.  phoradendri  fl 

Extr.  physostigmee 

Extr.  physostigmse  fl 

Extr.  Phytolacca;  baccarfl 

Extr.  phytolaccae  rad. 

Extr.  phytolaccse  rad.  fl. 

Extr.  pilocarpi  fl. 

Extr.  pimentse  fl. 

Extr.  piper  nigr.  fl. 

Extr.  piscidise  fl. 

Extr.  podophylli 

Extr.  podophylli  fl. 

Extr.  polygon!  fl. 

Extr.  polygonati  fl. 

Extr.  populi  fl.     . 

Extr.  prinos  fl. 

Extr.  prun.  virg.  fl. 

Extr.  pteles  fl.     . 

Extr.  pulsatillae  fl. 

Extr.  quassise 

Extr.  quassiae  fl. 

Extr.  quercus  fl.  . 

Extr.  rhamni  cath,  ft 

Extr.  rhamni  pursh.  cor 

Extr.  rhei    , 

Extr.  rhei  fl 

rhois  arom.  fl. 
rhois  glabr.  cort 
rhois  glabr.  fruct 
rhois  toxicol.  fl. 

Extr.  ricini  fol.  fl 

Extr.  rosse  fl.  . 

Extr.  rubi  fl.     . 

Extr.  rumicis  fl. 

Extr.  rutse  fl.  . 

Extr.  sabbatiae  fl. 

Extr.  sabinse  fl. 

Extr.  salicis  fl. 

Extr.  salvise  fl. 


Extr. 
Extr. 
Extr. 
Extr. 


Dose  in  metric  weights 
or  measures. 


2  to  lo  centigrams 
0.06  to  0.30  C.  c. 
0.30  to  I  C.  c.   . 
0.30  to  I  C.  c.   . 

I  to    2  C.  c. 

I  to    3  centigrams 

3  to  12  centigrams 

1  to    3  C.  c. 

2  to    4  C.  c. 

4  to    8  C.  c. 

4  to  8  C.  c.    .     . 

2  to    4  C.  c. 

4  to  10  milligrams 
0.06  to  0.20  C.  c. 
0.30  to  2  C.  c.   . 
6  to  20  centigrams 
0.30  to  2  C.  c.    . 
I  to    4  C.  c. 
I  to    3  C.  c. 
I  to    3  C.  c.      . 
I  to    4  C.  c. 

3  to  10  centigrams 
0.50  to  2  C.  c.  . 

1  to  2  C.  c.   .     . 
0.30  to  I  C.  c.   . 

2  to  4  C.  c.    .     . 
2  to    4  C.  c. 

2  to    4  C.  c. 

1  to  2  C.  c. 
o.io  to  0.30  C.  c. 
6  to  30  centigrams 

2  to  4  C.  c. 
2  to  4  C.  c. 
2  to  4  C.  c. 
2  to  8  C.  c. 
0.30  to  I  Gm.  . 
I  to  3  C.  c. 

1  to  4  C.  c. 

2  to  4  C.  c. 
2  to  4  C.  c. 
0.06  to  0.40  C.  c. 
2  to  8  C.  c. 

2  to  8  C.  c.   . 

1  to  4  C.  c. 

2  to  4  C.  c. 

1  to  2  C.  c. 

2  to  4  C.  c. 
0.30  to  I  C.  c.  . 
2  to  8  C.  c. 

2  to  8  C.  c.   . 


Dose   in  apothecaries' 
weights  or  measures. 


>^  to    iji  grains. 

I  to    5  minims. 

5  to  15  minims. 

5  to  15  minims. 
1 5  to  30  minims. 
yeto  }i  grain. 
}4  to    2  grains. 
15  to  45  minims. 
30  to  60  minims. 

I  to    2  fl.  drachms. 

I  to    2  fl.  drachms. 
)4  to    I  fl.  drachm. 
T6  to  ye  grain. 

I  to    3  minims. 

5  to  30  minims. 

1  to    3  grains. 
5  to  30  minims. 

15  to  60  minims. 
1 5  to  45  minims. 
15  to  45  minims. 
15  to  60  minims. 
}i  to  1%  grains. 

8  to  30  minims. 
15  to  30  minims. 

5  to  15  minims. 
30  to  60  minims. 
30  to  60  minims. 
30  to  60  minims. 
1 5  to  30  minims. 

2  to    5  minims. 
I  to    5  grains. 

30  to  60  minims. 
30  to  60  minims. 
30  to  60  minims. 
30  to  120  minims. 

5  to  15  grains. 
15  to  45  minims. 
15  to  60  minims. 
30  to  60  minims. 
30  to  60  minims. 

I  to  6  minims. 
yi  to  2  fl.  drachms, 
i^  to  2  fl.  drachms. 
15  to  60  minims. 
30  to  60  minims. 
15  to  30  minims. 
30  to  60  minims. 

5  to  15  minims. 
}^  to  2  fl.  drachms. 
^  to  2  fl.  drachms. 


POSOLOGICAL   TABLES. 


39 


DOSE  TABLE  CONTINUED. 


Remedies. 

Dose  in  metric  weights 
or  measures. 

Dose  in  apothecaries' 
weights  or  measures. 

Extr.  sambuci  fl.       ... 

2  to    8  C.  c.      .     . 

)4  to    2  fl.  drachms. 

Extr.  sanguin  fl.        ... 

0.30  to    I  C.  c.    .     . 

5  to  15  minims. 

Extr.  santali  citr.  fl.       .     . 

4  to    8  C.  c. 

I  to    2  fl.  drachms. 

Extr.  santonicse  fl.    .     .     . 

I  to    4  C.  c.       .     . 

15  to  60  minims. 

Extr.  sarsap.  fl 

2  to    8  C.  c.      .     . 

}4  to    2  fl.  drachms. 

Extr.  compt.  fl 

2  to    8  C.  c.      .     . 

>^  to    2  fl.  drachms. 

Extr.  sassafras    fl.    .     .     . 

2  to    8  C.  c. 

>^  to    2  fl.  drachms. 

Extr.  scills  fl 

0.30  to  2  C.  c.   .     . 

5  to  30  minims. 

Extr.  scillge  comp.  fl.     ,     . 

0.30  to  2  C.  c.    .     . 

5  to  30  minims. 

Extr.  scoparii  fl.        ... 

2  to    4  C.  c.       .     . 

J4  to     I  fl.  drachm. 

Extr.  scutellarice  fl.        .     . 

2  to    8  C.  c.       .     . 

>^  to    2  fl.  drachms. 

Extr.  senecionis  fl.    .     .     . 

4to    8C.  c.       .     . 

I  to    2  fl.  drachms. 

Extr.  senegae  fl 

0.50  to  I  C.  c.   .     . 

8  to  15  minims. 

Extr.  senna;  fl 

4  to  15  C.  c.      .     . 

I  to    4  fl.  drachms. 

Extr.  serpent,  fl.        ... 

2  to    4  C.  c.      .     . 

30  to  60  minims. 

Extr.  simarub£e  fl.     .     .     . 

I  to    2  C.  c.      .     . 

15  to  30  minims. 

Extr.  solidag.  fl 

2  to    4  C.  c.      .     . 

30  to  60  minims. 

Extr.  spigelice  fl.       ... 

I  to    4  C.  c.       .     . 

15  to  60  minims. 

Extr.  spigelice  et  sennae  fl. 

2  to    8  C.  c.       .     . 

>^  to    2  fl.  drachms. 

Extr.  stillingise  fl.     .     .     . 

2  to    8  C.  c.       .     . 

;^  to    2  fl.  drachms. 

Extr.  stillingiae  comp,  fl.    . 

2  to    8  C.  c.      .     . 

>^  to    2  fl.  drachms. 

Extr.  stramonii  (EngL) 

3  to    6  centigrams. 

^  to    I  grain. 

Extr.  stramonii  foL  ale.     . 

2  to    4  centigrams. 

K  to  %  grain. 

Extr.  stramonii  sem.      .     . 

I  to    3  centigrams, 

y^  to  j4.  grain. 

Extr.  stramonii  fl.     .     .     . 

0.06  to  0.40  C.  c.    . 

I  to    6  minims. 

Extr.  sumbul  fl 

I  to    4  C.  c.       .     . 

15  to  60  minims. 

Extr.  taraxaci       .... 

0.30  to  I  Gm.    .     . 

5  to  15  grains. 

Extr.  taraxaci  fl.        ... 

2  to    8  C.  c.       .     . 

>^  to  2  fl.  drachms. 

Extr.  thuJEe  fl 

0.50  to  I  C.  c.   .     . 

8  to  15  minims. 

Extr.  toxicodendri  fl.     .     . 

0.06  to  0.30  C.  c.    . 

I  to    5  minims. 

Extr.  trifol.  prat,  fl.        .     . 

4  to    8  C.  c.       .     . 

1  to    2  fl.  drachm. 

Extr.  trillii  fl 

2  to    8  C.  c.      .     . 

>^  to    2  fl.  drachms. 

Extr.  trit.  rep.  fl.        .     .     . 

4  to  15  C.  c.      .     . 

I  to    4  fl.  drachms. 

Extr.  tussilag.  fl 

2  to    4  C.  c.      .     . 

30  to  60  minims. 

Extr.  urticce  rad.  fl.       .     . 

0.30  10  I  C.  c.     .     . 

5  to  15  minims. 

Extr.  ustilag.  maid.  fl. 

I  to    4  C.  c.      .     . 

1 5  to  60  minims. 

Extr.  uvge  ursi  fl.      .     .     . 

2  to    4  C.  c.      .     . 

30  to  60  minims. 

Extr.  vaccin.  crassifol.  fl. 

2  to    4  C.  c.      .     . 

30  to  60  minims. 

Extr.  valer 

0.30  to  I  Gm.    .     . 

5  to  15  grains. 

Extr.  valer.  fl 

2  to    4  C.  c.       .     . 

30  to  60  minims. 

Extr.  veratr.  vir.  fl.  .     .     . 

o.io  to  0.50  C.  c.   . 

2  to    8  minims. 

Extr.  verbense  fl.      .     .     . 

I  to    4  C.  c.       .     . 

15  to  60  minims. 

Extr.  viburni  opuli  fl.    .     . 

4  to    8  C.  c.      .     . 

I  to    2  fl.  drachms. 

Extr.  viburni  [prunifol.]  fl. 

4  to    8  C.  c.       .     . 

I  to    2  fl.  drachms. 

Extr.  xanthoxyli  cort.  fl.    . 

I  to    2  C.  c.       .     . 

1 5  to  30  minims. 

Extr.  xanthoxyli  fruct.  fl. 

I  to    2  C.  c.      .     . 

15  to  30  minims. 

Extr.  zingiberis  fl.     .     .     . 

0.50  to  2  C.  c.    .     . 

8  to  30  minims. 

Fel  bovis  purif.     .     .     .     . 

20  to  40  centigrams. 

3  to    6  grains. 

Ferriarsen 

3  to  30  milligrams. 

^ffto  %  grain. 

Ferri  benzoas       .     .     .     . 

5  to  30  centigrams. 

I  to    5  grains. 

40 


DENTAL   MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies. 


Ferri  bromid  .  .  . 
Ferri  carb.  sacch.  . 
Ferri  chlorid.        .     . 

Ferri  citr 

Ferri  et  ammon.  citr. 
Ferri  et  ammon.  sulph 
Ferri  et  ammon.  tartr 
Ferri  et  cinchonid.  citr 
Ferri  et  pot.  tartr 
Ferri  et  quin.  citr.     . 
Ferri  et  strychn.  citr 
Ferri  ferrocyanid 
Ferri  hypophosphis  . 
Ferri  iodidum       ,     . 
Ferri  iodidum  sacch 
Ferri  lactas      .     ,     . 
Ferri  oxalas     .     • 
Ferri  oxid.  magnet  . 
Ferri  oxid.  hydrat     . 
Ferri  phosphas     .     . 
Ferri  pyrophosphas  . 
Ferri  subcarb  .     .     . 
Ferri  sulphas   .     .     . 
Ferri  sulphas  exsiccat 
Ferri  valer  .... 
Ferrum  dialys 
Ferrum  reduct 

Guarana 

Hydrarg.  chlorid.  corros 
Hydrarg.  chlorid.  mite 
Hydrarg  cyanid  .     .     . 
Hydrarg.  iodid.  flav 
Hydrarg.  iodid.  nibr     . 
Hydrarg.  iodid.  vir  .     . 
Hydrarg.  oxid.  flav  .     . 
Hydrarg.  oxid.  nigr .     . 
Hydrarg.  oxid.  rubr 
Hydrarg.  subsulphas  flav 
Hydrarg.  c.  creta      .     . 
Hyoscyamiina,  and  salts 
Infusum  brayerse      .     . 
Infusum  digitalis .     ,     . 
Infusum  sennse  comp    . 
lodoformum    .... 
lodum     .     .     .     •     .     . 

Ipecacuanha  }  l"^^^^^  ; 

Jalapa 

Kamala  , 

Kino 


Dose  in  metric  weights 
or  measures. 


5  to  30  centigrams 
0.25  to  I  Gm  .     . 

5  to  20  centigrams 
30  to  60  centigrams 
30  to  60  centigrams 
30  to  60  centigrams 
0.30  to  I  Gm  .  . 
30  to  60  centigrams 

I  to    4  Gm   .     . 
30  to  60  centigrams 

5  to  30  centigrams 
20  to  30  centigrams 
30  to  60  centigrams 

5  to  30  centigrams 
10  to  60  centigrams 

5  to  20  centigrams 

5  to  20  centigrams 
30  to  60  centigrams 
1 5  to  60  Gm    .     . 

5  to  30  centigrams 

5  to  30  centigrams 
0.30  to  2  Gm  .     . 

5  to  20  centigrams 

3  to  10  centigrams 

5  to  20  centigrams 
0.06  to  I  C.  c  .     . 

6  to  30  centigrams 
0.50  to  2  Gm  .     . 

I  to  6  milligrams 
I  to  50  centigrams 

4  to  30  milligrams 
I  to  6  centigrams 
4  to  30  milligrams 
I  to  6  centigrams 
4  to  30  milligrams 
6  to  60  milligrams 

4  to  30  miUigrams 
1 5  to  60  milligrams 
15  to  50  centigrams 
0.50  to  2  milligrams 
60  to  250  C.  c 

8  to  15  C.  c  .     . 
30  to  60  C.  c  .     . 

5  to  20  centigrams 
I  to  3  centigrams 
I  to  6  centigrams 
I  to    2  Gm    .     . 

I  to    2  Gm    .     . 
4  to    8  Gm  .     . 


0.50  to  2  Gm 


Dose  in  apothecaries' 
weights  or  measures. 


10 
_1_ 
16 

X 

3 
1 

2 
2 
I 
I 

ye 

15 

15 

I 


to  5 
to  15 
to  3 
to  10 
to  10 
to  10 
to  15 
to  10 
to  60 
to  10 

to  5 
to  5 
to  10 
to  5 
to  10 
to  3 
to  3 
to  10 

to     2 

to  5 
to  5 
to  30 
to  3 
to  I 
to  3 
to  15 
to  5 
to  30 

tOiV 

to  8 
to>^ 
to     I 

to  }4 

to     I 

to  y2 

to  I 
to  }4 
to  I 
to    8 

to   3^; 

to    8 

to    4 

to     2 

to    3 

to  )4 

to  I 
to  30 
to  30 

to     2 

to  30 


grams, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
grains, 
ounces, 
grains, 
grains, 
grains, 
grains. 
jl  grains, 
grains, 
minims, 
grains, 
grains, 
grain, 
grains, 
grain, 
grain, 
grain, 
grain, 
grain, 
grain, 
grain, 
grain, 
grains. 
;  grain, 
fl.  ounces, 
fl.  drachms. 
fl.  ounces, 
grains, 
grain, 
grain, 
grains, 
grains, 
drachms, 
grains. 


POSOLOGICAL   TABLES. 


41 


DOSE  TABLE  CONTINUED. 


Remedies. 

Dose  in  metric  weights 
or  measures. 

Dose  in  apothecaries' 
weights  or  measures. 

Lactucarium 

0.50  to  I  Gm  .     .     . 

8  to  15  grains. 

Liq.  ammon.  acet     .     .     . 

8  to  30  C.  c  .     .     . 

2  to    8  fl.  drachms. 

Liq.  acidi  arseniosi  .     .     . 

o.io  to  0.50  C.  c  .     . 

2  to    7  minims. 

Liq.  arsen.  et  hydr.  iod 

o.io  to  0.50  C.  c  .     . 

2  to    7  minims. 

Liq.  ferri  chloridi      .     .     . 

O.IO  to  0.60  C.  c  .     . 

2  to  10  minims. 

Liq.  ferri  dialys    .     .     .     . 

0.06  to  I  C.  c  .    .     . 

I  to  15  minims. 

Liq.  ferri  nitrat     .     .     .     . 

0.50  to  I  C.  c  .     .     . 

8  to  15  minims. 

Liq.  pepsini 

8  to  1 5  C.  c  .     .     . 

2  to    4  fl.  drachms. 

Liquor  potassae     .     .     .     . 

0.30  to  2  C.  c.     .     . 

5  to  30  minims. 

Liquor  potassii  arsenit  .     . 

0.15  to  0.50  C.  c.     . 

3  to    7  minims. 

Liquor  potassii  citrat      .     . 

8  to  15  C.  c  .     .     . 

2  to    4  fl.  drachms. 

Liquor  sodcC 

0.30  to  2  C.  c  .     .     . 

5  to  30  minims. 
3  to    7  minims. 

Liquor  sodii  arseniatis  .     . 

0.15  to  0.50  C.  c  .     . 

Lithii  benzoas 

10  to  30  centigrams. 

2  to    5  grains. 

Lithii  bromid 

6  to  20  centigrams. 

I  to    3  grains. 

Lithii  carb 

10  to  40  centigrams. 

2  to    6  grains. 

Lithii  citr 

10  to  30  centigrams. 

2  to    5  grains. 

Lithii  salicylas      .     .     .     . 

10  to  50  centigrams. 

2  to    8  grains. 

Lupulinum 

30  to  60  centigrams. 

5  to  10  grains. 

Magnesia 

I  to    4  Gm   .     .     . 

15  to  60  grains. 

Magnesii  carb      .     .     .     . 

I  to    4  Gm  .     .     . 

15  to  60  grains. 

Magnesii  citr.  gran  .     .     . 

8  to  30  Gm   .     .     . 

2  to    8  drachms. 

Magnesii  sulphas      .     .     . 

8  to  30  Gm   .     .     . 

2  to    8  drachms. 

Magnesii  sulphis       .     .     . 

0.50  to  2  Gm  .     .     . 

8  to  30  grains. 

Mangani  sulphas      .     .     . 

10  to  60  centigrams. 

2  to  10  grains. 

Manna •     . 

30  to  60  Gm    .     .     . 

I  to  2  ounces. 

Massa  copaibse    .... 

0.30  to  2  Gm  .     .     . 

5  to  30  grains. 

Massa  ferri  carb   .... 

0.30  to  I  Gm  .     .     . 

5  to  15  grains. 

Massa  hydrarg     .... 

0.06  to  I  Gm  .     .     . 

I  to  15  grains. 

Mist,  ammoniaci.     .     .     . 

15  to  30  C.  c  .     .     . 

4  to    8  fl.  drachms. 

Mist,  asafoetidae   .... 

15  to  30  C.  c  .     .     . 

4  to    8  fl.  drachms. 

Mist,  chloroformi      .     .     . 

15  to  30  C.  c  .     .     . 

4  to    8  fl.  drachms. 

Mist,  cretae 

30  to  60  C.  c  .     .     . 

I  to    2  fl.  ounces 

Mist,  ferri  comp    .... 

15  to  60  C.  c  .     .     . 

^  to    2  fl.  ounces. 

Mist,  ferri  et  ammon.  acet. 

15  to  30  C.  c  .     .     . 

_^  to    I  fl.  ounce. 

Mist,  glycrrh.  comp .     .     . 

4  to  15  C.  c  .     .     . 

I  to    4  fl.  drachms. 

Mist,  magnes.  et  asafoet     . 

4  to  15  C.  c  .     .     . 

I  to    4  fl.  drachms. 

Mist,  potassii  citr.      .     .     . 

15  to  60  C.  c  .     .     . 

>^  to    2  fl.  ounces. 

Mist,  rhei  et  sodae     .     .     . 

15  to  30  C.  c  .     .     . 

;^  to    I  fl.  ounce. 

Morphina,  and  its  salts.     . 

4  to  30  milligrams. 

T6  to  X  grain. 

Moschus 

O.IO  to  1  Gm  . 

2  to  1 5  grains. 
Ye  to    2  grains. 

Narceina 

I  to  10  centigrams. 

Nitroglycerinum  .... 

I  to    4  milligrams. 

eV  to  tV  grain. 

Nux  vomica 

5  to  30  centigrams. 

I  to    5  grains. 

Oleoresina  aspidii     .     .     . 

I  to    4  Gm    .     .     . 

15  to  60  grains. 

Oleoresina  capsici     .     .     . 

I  to    3  milligrams. 

YetoYz  grain. 

Oleoresina  cubebs  .     .     . 

0.30  to  2  Gm  .     .     . 

5  to  30  grains. 

Oleoresina  lupulini  .     .     . 

10  to  30  centigrams. 

2  to    5  grains. 

Oleoresina  piperis     .     .     . 

6  to  20  centigrams. 

I  to    3  grains. 

Oleoresina  zingiberis     .     . 

6  to  20  centigrams. 

I  to    3  grains. 

42 


DENTAL   MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies. 


Oleum  copaibse  .  .  . 
Oleum  cubebae  .  .  . 
Oleum  eriger  .... 
Oleum  eucalypti  .  .  . 
Oleum  phosphoratum  . 
Oleum  sabinse  .  .  . 
Oleum  terebinth  .  .  . 
Oleum  tiglii  .... 
Opium  (14%  morphine) 
Pepsinum  purum .  .  . 
Pepsinum  saccharatum 
Phosphorus  .... 
Physostigminse  salicylas 
Physostigminse  sulphas 
Picrotoxinum  .... 
Pilocarpina  (and  salts) 
Pil.  aloes  .  .  . 
Pil.  aloes  et  asafoet 
Pil.  aloes  et  ferri  . 
Pil.  aloes  et  mast 
Pil.  aloes  et  myrrhse 
Pil.  antimon.  comp 
Pil.  asafoetidce 
Pil.  cathart.  comp 
Pil.  ferri  comp 
Pil.  ferri  iodidi 
Pil.  galbani  comp 
Pil.  opii  .  .  . 
Pil.  phosphori . 
Pil.  rhei  .  .  . 
Pil.  rhei  comp 
Piperinum  .  . 
Plumbi  acetas . 
Plumbi  iodidum 
Potassii  acetas 
Potassii  bicarb 
Potassii  bitartr 
Potassii  bromid 
Potassii  carb  . 
Potassii  chloras 
Potassii  citras  . 
Potassii  cyanid 
Potassii  et  sodii  tartr 
Potassii  hypophosph 
Potassii  iodid  . 
Potassii  nitras .  . 
Potassii  sulphas  . 
Potassii  sulphidum 
Potassii  sulphis  . 
Potassii  tartras 


Dose  in  metric  weights 
or  measures. 


0.50  to  I  C.  C 

I  to  2  C.  C      .       . 
0.30  to  I  C.  C 
0.60  to  2  C.  C 

5  to  20  centigrams 
0.06  to  0.20  C.c  . 
0.30  to  2  C.  c  .     . 
I  to  10  centigrams 
I  to  10  centigrams 

1  to  15  Gm  .     . 

2  to  30  Gm   .     . 
0.50  to  3  milligrams 
0.50  to  I  milligram 
0.50  to  I  milligram 

I  to  8  milligrams 
I  to  30  milligrams 
I  to    3  pills  . 

5  pills  . 

3  pills  . 

3  pills  . 

5  pills  . 

3  pills  . 

6  pills  . 

4  pills  . 

5  pills  . 

4  pills  . 

5  pills  . 
2  pills  . 

4  pills  . 

5  pills  . 
5  pills  . 

5  to  50  centigrams 

3  to  20  centigrams 

3  to  20  centigrams 
I  to  4  Gm     .     . 

0.50  to  4  Gm  .  . 

4  to  8  Gm  .  . 
0.50  to  4  Gm  .  . 
0.50  to  2  Gm  .  . 
0.50  to  2  Gm  .  . 

I  to  4  Gm     .  . 

4  to  8  milligrams 
1 5  to  30  Gm  .  . 
0.30  to  I  Gm  .  . 
o.io  to  I  Gm  .  . 
0.50  to  I  Gm  .  . 
^4toi5Gm. 

5  to  60  centigrams 
I  to    2  Gm. 

5  to  30  Gm. 


to 
to 
to 
to 
to 
to 

1  to 

2  to 
I  to 
I  to 
I  to 

1  to 

2  to 

2  to 


Dose  in  apothecaries' 
weights  or  measures. 


8  to  15  minims. 
15  to  30  minims. 

5  to  1 5  minims. 
10  to  30  minims. 

I  to    3  grains. 

I  to    3  minims. 

5  to  30  minims. 
y^  to  1)4  grains. 
ye  to  1%  grains. 
15  grains  to  Yz  ounce. 
30  grains  to  i  ounce. 
128  to  2V  grain. 
T2o  to  s^i  grain. 
T2-8  to  eV  grain. 
in  to  y&  grain. 
'Si  to  yz  grain. 

1  to    3  pills. 

2  to  5  pills. 
I  to    3  pills. 

1  to    3  pills. 

2  to  5  pills. 
I  to  3  pills. 
I  to    6  pills. 

1  to    4  pills. 

2  to  5  pills. 
I  to  4  pills. 
I  to  5  pills. 
I  to    2  pills. 

1  to    4  pills. 

2  to  5  pills. 
2  to    5  pills. 

I  to  8  grains. 
yi  to  2>  grains. 
yz  to  2)  grains. 
1 5  to  60  grains. 

8  to  60  grains. 

1  to  2  grains. 
8  to  60  grains. 
8  to  30  grains, 
8  to  30  grains. 

15  to  60  grains. 
jV  to  }i  grain. 
Yz  to    I  ounce. 
5  to  1 5  grains. 

2  to  15  grains. 
8  to  15  grains. 

I  to    4  drachms. 
I  to  10  grains. 
15  to  30  grains. 
I  to    8  drachms. 


POSOLOGICAL    TABLES. 


43 


DOSE  TABLE  CONTINUED. 


Remedies. 


Pulv.  antimonialis 
Pulv.  aromat. 
Pulv.  Crete  comp. 
Pulv.  glycyrrh.  comp. 
Pulv.  ipecac  et  opii 
Pulv.  jalapae  comp. 
Pulv.  morphinas  comp. 
Pulv.  rhei  comp. 
Ouinidina  (and  salts) 
Quinina  (and  salts) 
Ouininse  arsenias 
Resina  copaibse 
Resina  jalaptE 
Resina  podophylli 
Resina  scammonii 
Rheum   .     .     . 
Salicinum    . 
Santonica    . 
Santoninum 
Sapo  .     .     . 
Scammonium 
Senna     .     .     , 
Sodii  acetas 
Sodii  arsenias 
Sodii  benzoas 
Sodii  bicarb.    . 
Sodii  bisulphis 
Sodii  boras 
Sodii  bromid. 
Sodii  carb. 
Sodii  carb.  exsicc 
Sodii  chloras    .     . 
Sodii  hypophosphis 
Sodii  hyposulphis 
Sodii  iodidum 
Sodii  phosphas     . 
Sodii  salicylas 
Sodii  santoninas  . 
Sodii  sulphas  . 
Sodii  sulphis     .    . 
Spir.  sether.       .     . 
Spir.  sether.  nitrosi 
Spir.  ammonise     . 
Spir.  ammo  nice  arom 
Spir.  camphorae    . 
Spir.  chloroform! 
Spir.  lavend.  comp 
Spir.  menth.  pip. 
Strychnina  (and  salts 
Sulphur  .     . 


Dose  in  metric  weights 
or  measures. 


to  60  centigrams 
50  to  2  Gm. 
,50  to  2  Gm. 
to    4  Gm. 
,30  to  I  Gm. 
to    4  Gm. 
.50  to  I  Gm. 
to  4  Gm.    . 
.05  to  2  Gm. 
.05  to  2  Gm. 
to    5  centigrams 
to  60  centigrams 
to  30  centigrams 
to  30  milligrams 
to  60  centigrams 
.10  to  2  Gm.    . 
.50  to  2  Gm.    . 
.50  to  4  Gm.    . 
to  30  centigrams 
.30  to  2  Gm.    . 
.20  to  I  Gm.    . 
.50  to  4  Gm.    . 
to    4  Gm. 
to    6  milligrams 
.30  to  I  Gm.    . 
.50  to  2  Gm.    . 
.50  to  2  Gm.    . 
.50  to  2  Gm.    . 
,50  to  2  Gm.    . 
,50  to  2  Gm.    . 
,30  to  I  Gm.    . 
,30  to  2  Gm.    . 
,50  to  I  Gm.    . 
.50  to  2  Gm.    . 
,30  to  I  Gm.    . 
,10  to  I  Gm.    . 
,30  to  2  Gm.    . 
to  60  centigrams 
to  30  Gm. 
,50  to  2  Gm.    . 
to    4  C.  c. 
to    8  C.  c. 
.50  to  2  C.  c.    . 
to    4  C.  c. 
,50  to  2  C.  c.    . 
to    4  C.  c. 
to    4  C.  c. 
to    4  C.  c. 
to    5  milligrams 
to  15  Gm. 


Dose  in  apothecaries' 
weights  or  measures. 


3  to 
8  to 
8  to 

30  to 
5  to 

30  to 
8  to 

30  to 
I  to 

1  to 
Yt  to 

2  to 

2  to 

yi  to 

2  to 

2  to 

8  to 
8  to 

1  to 
5  to 

3  to 
8  to 

15  to 

6^?  to 

5  to 
8  to 
8  to 
8  to 
8  to 
8  to 
5  to 
5  to 
8  to 
8  to 
5  to 

2  to 
5  to 
2  to 
I  to 
8  to 

30  to 

Yz   to 

8  to 
15  to 

8  to 
15  to 
30  to 
30  to 

e^tO 
^tO 


10  grains. 
30  grains. 
30  grains. 
60  grains. 
15  grains. 
60  grains. 
15  grains. 
60  grains. 
30  grains. 
30  grains. 

1  grain. 
10  grains. 

5  grains. 
Yi  grain. 
10  grains. 
30  grains. 
30  grains. 
60  grains. 

5  grains. 
30  grains. 
15  grains. 
60  grains. 
60  grains. 
xV  grain. 
15  grains. 
30  grains. 
30  grains. 
30  grains. 
30  grains. 
30  grains. 
15  grains. 
30  grains. 
15  grains. 
30  grains. 
15  grains. 
15  grains. 
30  grains. 
10  grains. 

2  grains. 
30  grains. 
60  minims. 

2  fl.  drachms. 
30  minims. 
60  minims. 
30  minims. 
60  minims. 
60  minims. 
60  minims. 
j-V  grain. 

4  drachms. 


44 


DENTAL    MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies. 


Syrupus  acidi  hydroiodici 
Syrupus  allii    .... 
Syrupus  calcii  lactophos 
Syrupus  calcis      .     . 
Syrupus  ferri  bromidi    . 
Syrupus  ferri  iodidi 
Syrupus  ferri  oxidi    .     . 
Syrupus  ferri  hypophosph 
Syr.  fer.,  quin  et  str.  phos 
Syrupus  hypophosphit. 
Syrupus  hypophos.  c.  fer. 
Syrupus  ipecac     .     . 
Syrupus  kramerise     . 
Syrupus  lactucarii     . 
Syrupus  rhei    .     . 
Syrupus  rhei  arom. 
Syrupus  rosae 
Syrupus  rubi    .     .     . 
Syrupus  sarsap.  comp. 
Syrupus  scillas      .     . 
Syrupus  scillae  comp. 
Syrupus  senegse 
Syrupus  sennae     .     . 
Tinct.  aconiti  fol.     , 
Tinct.  aconiti  rad.    . 
Tinct.  aeon. rad.  Flemin 
Tinct.  aloes  (1880)    . 
Tinct.  aloes  et  myrrhse 
Tinct.  arnicse  flor.    . 
Tinct.  arnicee  rad.     . 
Tinct.  asafoetidas 
Tinct.  belladonnas    . 
Tinct.  bryoniae     .     . 
Tinct.  calendulae 
Tinct.  calumbas  .     . 
Tinct.  cannabis  ind. 
Tinct.  cantharid. 
Tinct.  capsici        .     . 
Tinct.  catechu  comp. 
Tinct.  chiratae      .     . 
Tinct.  cimicifugae 
Tinct.  cinchonse 
Tinct.  cinchonae  comp, 
Tinct.  colchici  rad.  . 
Tinct.  colchici  sem. 
Tinct.  conii      .      .     . 
Tinct.  croci     .     .     . 
Tinct.  cubebae      .     . 
Tinct.  digitalis     .     . 
Tinct.  ferri  acet. 


Dose  in  metric  weights 
or  measures. 


5  to 
5  to 
I  to 
I  to 

1  to 
5C. 
5C. 
5C. 
5C. 
5C. 

2  to 
2  to 
5  to 
4  to 
4  to 
4  to 
4  to 
4  to 
2  to 

1  to 

4  to 

5  to 
0.50 
0.06 
0.04 

2  to 
4  to 
0.50 

1  to 

2  to 
0.30 

I  to 
I  to 

3  to 

1  to 
0.50 
0.50 

2  to 

1  to 

2  to 
2  to 
2  to 
0.30 
0.30 
0.30 

4  to 
4  to 

0.30 

I  to 


c. 
c. 
c. 
c. 
c. 


15  c 
10  c 

2  C 

4C 
4C, 

c. 

c. 

c. 

c. 

c. 

15  C.  c. 

15  C.  c. 

10  C.  c. 

15  C.  c. 

15,  C. 

8  C. 

8  C. 
15  C. 

4C. 

4C. 

8  C. 
15  C. 
to  I  C.  c. 
to  0.30  C 
to  0.15  C, 
8  C.  c.  . 
8  C.  c.  . 
to  2  C.  c. 

2  C.  c. 

4  C.  c. 
to  I  C.  c. 

2  C.  c. 

2  C.  c. 
15  C.  c. 

2  C.  c. 
to  I  C.  c. 
to  I  C.  c. 

8  C.  c. 

4  C.  c. 

4  C.  c. 

8  C.  c. 

8  C.  c. 
to  I  C.  c. 
to  I  C.  c. 
to  2  C.  c. 

8  C.  c. 

8  C.  c. 
to  I  C.  c. 

2  C.  c. 


Dose  in  apothecaries' 
weights  or  measures. 


I  to    4  fl.  drachms. 

I  to    2  fl.  drachms. 
1 5  to  30  minims. 
15  to  60  minims. 
15  to  60  minims. 

I  fl.  drachm. 

I  fl.  drachm. 

I  fl.  drachm. 


drachm, 
drachm, 

4  fl.  drachms. 

4  fl.  drachms. 

3  fl.  drachms. 

4  fl.  drachms. 
4  fl.  drachms. 
2  fl.  drachms. 
2  fl.  drachms. 
4  fl.  drachms. 

1  fl.  drachm, 
o  60  minims. 

o    2  fl.  drachms. 

4  fl.  drachms. 
16  minims. 

5  minims. 
nyi  minims. 

2  fl.  drachms. 
2  fl.  drachms. 

o  30  minims, 
o  30  minims, 
o  60  minims, 
o  15  minims, 
o  30  minims, 
o  30  minims. 
4  fl.  drachms. 
30  minims. 
15  minims. 
15  minims. 
2  fl.  drachms, 
o  60  minims. 
0  60  minims. 
o    2  fl.  drachms. 
2  fl.  drachms. 
15  minims. 
15  minims. 
30  minims. 
2  fl.  drachms. 
2  fl.  drachms. 
0  15  minims, 
o  30  minims. 


POSOLOGICAL    TABLES. 


45 


DOSE  TABLE  CONTINUED. 

Remedies. 

Dose  in  metric  weights 
or  measures. 

Dose  in  apothecaries' 
weights  or  measures. 

Tinct.  ferri  chloridi       .     . 

I  to      2  C.  C  .       .       . 

15  to  30  minims. 

Tinct.  ferri  chloridi  aether. 

I  to     2  C.  C  . 

15  to  30  minims, 

Tinct.  ferri  pomati    .     .     . 

2  to     4  C.  C  . 

20  to  60  minims. 

Tinct.  gallae 

2  to     8  C.  C  . 

)4  to  2  {[.  drachms. 
8  to  15  minims. 

Tinct.  gelsemii      .     . 

0.50  to  I  C.  c 

Tinct.  guaiaci       .     . 

2  to     4  C.  C    . 

30  to  60  minims. 

Tinct.  guaiaci  ammon. 

2  to     4  C.  C    . 

30  to  60  minims. 

Tinct.  hellebori    .     . 

0.60  to  I  C.  c 

10  to  15  minims. 

Tinct.  humuh  . 

4  to  10  C.  c  . 
2  to    6  C.  c  . 

I  to  2>^  fl.  drachms. 
30  to  90  minims. 

Tinct.  hydrastis    .     . 

Tinct.  hyoscyami  fol 

I  to    4  C.  c  . 

15  to  60  minims. 

Tinct.  hyoscyami  sem 

I  to     2  C.  C  . 

15  to  30  minims. 

Tinct.  ignatiae      .     . 

0.30  to  I  C.  c 

5  to  15  minims. 

Tinct.  iodi   .... 

0.30  to  I  C.  c 

5  to  15  minims. 
5  to  15  minims. 

Tinct.  ipecac,  et  opii 

0.30  to  I  C.  c 

Tinct.  jalapse  . 

2  to    8  C.  c  . 
2  to    8  C.  c  . 
2  to    8  C.  c  . 

^  to  2  fl.  drachms. 
^  to  2  fl.  drachms. 
)^  to  2  fl.  drachms. 

Tinct.  kino .... 

Tinct.  krameriEe  .     . 

Tinct.  lavend.  comp 

2  to    8  C.  c  , 

>^  to  2  fl.  drachms. 

Tinct.  lobehse  . 

1  to    3  C.  c  . 

2  to    8  C.  c  . 

15  to  45  minims. 
>^  to  2  fl.  drachms. 

Tinct.  lupuHni      .     . 

Tinct.  matico  . 

2  to    8  C.  c  .  . 
I  to    4  C.  c  . 

)4  to  2  a.  drachms. 
15  to  60  minims. 

Tinct.  moschi       .     .     . 

Tinct.  nux  vomicae    . 

0.50  to  3  C.  c 

8  to  45  minims. 

Tinct.  opii  .... 

0.30  to  I  C.  c 

5  to  15  minims. 
8  to  75  minims. 

Tinct.  opii  camph     . 

0.50  to  5  C.  c 

Tinct.  phytolaccae     . 

0.50  to  4  C.  c 

8  to  60  minims. 

Tinct.  physostigmatis 

0.30  to  I  C.  c 

5  to  1 5  minims. 

Tinct.  pyrethri      .     . 

0.50  to  2  C.  c 

8  to  30  minims. 

Tinct.  quassise      .     . 

2  to    8  C.  c  . 

j^  to    2  fl.  drachms. 

Tinct.  rhei  .... 

4  to  30  C.  c  . 
2  to    5  C.  c  . 

I  to    8.  fl.  drachms. 

Tinct.  rhei  arom  .     . 

30  to  75  minims. 

Tinct.  rhei  dul      .     . 

4  to  15  C.  c  . 

I  to    4  fl.  drachms. 

Tinct.  sanguinariee  . 

I  to    4  C.  c  . 

1 5  to  60  minims. 

Tinct.  scillge     .     .     , 

0.50  to  4  C.  c 

8  to  60  minims. 

Tinct.  serpentariae    . 

2  to    8  C.  c  . 

^  to    2  fl.  drachms. 

Tinct.  stramon.  fol    .     . 

0.50  to  I  C.  c 

8  to  15  minims. 

Tinct.  stramon.  sem 

.0.30  to  I  C.  c 

6  to  1 5  minims. 

Tinct.  sumbul .... 

0.50  to  2  C.  c 

8  to  30  minims. 

Tinct.  valer     .     .     , 

2  to    8  C.  c  .     . 

>^  to    2  fl.  drachms. 

Tinct.  valer.  ammon     . 

2  to    8  C.  c  . 

^  to    2  fl.  drachms. 

Tinct.  veratr.  vir  .     ,     . 

0.20  to  0.60  C.  c 

3  to  10  minims. 

Tinct.  zingiberis  .     .     . 

I  to    4  C.  c  . 

15  to  60  minims. 

Tritur.  elaterini    .     .     . 

8  to  30  milligrams. 

%  to  )4  grain. 

Veratrina 

I  to    6  milligrams. 

ij?  to  xV  grain. 
I  to    2  fl.  drachms. 

Vin.  aloes    

4  to    8  C.  c  .     .     - 

Vin.  antimj^'^P^^^-^t 

alt 

0.06  to  0.50  C.  c 

I  to    8  minims. 

1  emet    .     . 

2  to    5  C.  c  . 

30  to  75  minims. 

Vin.  colch.  rad     .     ,     . 

0.50  to  3  C.  c 

8  to  45  minims. 

Vin.  colch.  sem     .     .     . 

0.30  to  2  C.  c 

5  to  30  minims. 

46 


DENTAL    MEDICINE. 


DOSE  TABLE  CONTINUED. 


Remedies 


Vin.  ergotse  .  .  . 
Vin.  ferri  amar  .  . 
Vin.  ferri  citrat  .  . 
f  expect 


I  emet 


Vin.  ipecac. 

Vin.  opii 
Vin.  rhei 
Zinci  acet    . 
Zinci  bromid 
Zinci  iodid  . 
Zinci  oxid    . 
Zinci  phosphid 
Zinci  sulphas  emet 
Zinci  valerianas  . 


Dose  in  metric  weights 
or  measures. 


4  to  12 

5  Co. 
5  C.  c  . 

0.30  to  I 
10  to  25 
0.30  to  I 

4  to    8 

5  to  12 
3  to  10 
3  to  15 

6  to  60 

5  to  10 
I  to    2 

6  to  40 


C.  c  . 


C.  c 
C.  c  . 

C.  c 
C.  c  . 
centigrams 
centigrams 
centigrams 
centigrams 
milligrams 
Gm  .  . 
centierrams 


Dose  in  apothecaries' 
weights  or  measures. 


I  to 
I  fl. 
I  fl. 

5  to 

3  to 

5  to 

I  to 

I  to 

Yz  to 

Yz  to 

I  to 

xVto 

15  to 

I  to 


3  fl.  drachms, 
drachm, 
drachm. 
15  minims. 

6  fl.  drachms. 
15  minims. 

2  fl.  drachms. 

2  grains. 

2  grains. 

3  grains. 
10  grains. 
Y(>  grain. 
30  grains. 

6  grains. 


POISONS. 

SYMPTOMS   AND   ANTIDOTES. 

Cases  of  poisoning  require  the  prompt  administration  of 
remedies,  and  hence,  a  knowledge  of  the  usual  antidotes  is 
requisite,  in  order  that  they  may  be  employed  with  effect. 

For  the  majority  of  such  cases,  the  chief  reliance  should  be 
upon  emetics,  so  that  free  vomiting  may  be  induced  by  such 
articles  of  this  class  which  are  most  speedy  in  their  effect. 
Sulphate  of  zinc  is  preferred  by  many,  and,  if  vomiting  is 
present,  it  may  be  aided  by  diluents  or  a  vegetable  emetic. 
When  the  poisonous  substance  has  remained  for  any  length  of 
time  in  the  stomach,  the  use  of  emetics  will  not  prove  sufficient, 
but  resort  must  be  had  to  the  stomach-tube  and  syringe. 
Milk,  lime-water,  soap,  or  solutions  of  sugar  or  honey  will 
protect  the  stomach  and  intestines,  while  oil  and  other  fatty 
matters  may  prove  injurious.  Carbonate  of  magnesia  with 
tincture  of  opium,  suspended  in  water,  freely  administered, 
will  prove  very  serviceable  after  the  vomiting  has  ceased,  and 
the  patient  is  suffering  from  retching  and  pain. 

When  the  nature  of  the  poison  is  unknown,  a  general  anti- 
dote, consisting  of  equal  parts  of  calcined  magnesia,  pulverized 
charcoal,  and  hydrated  peroxide  of  iron,  which  are  to  be 
diffused  in  water,  may  be  freely  administered,  and  will,  in  the 


POISONS.  47 


majority  of  cases,  prove  efficient,  as  one  or  another  of  them  is 
an  antidote  to  most  of  the  mineral  poisons. 

The  albumen  of  eggs  and  tannic  acid  are  also  considered  to 
be  valuable  antidotes.  The  albumen  neutralizes  corrosive 
sublimate  and  like  salts,  and  the  tannic  acid  precipitates  all  of 
the  vegetable  alkaloids  as  tannates. 

ACIDS  {Mineral). 

Symptoms.  Corrosion  of  parts  with  which  the  acid  comes 
in  contact,  with  an  immediate  burning  pain  in  mouth,  throat, 
oesophagus  and  stomach  ;  vomiting  of  liquid  impregnated  with 
mucus  and  blood.  Death  occurs  from  inflammation,  or  from 
asphyxia. 

Antidotes.     Chalk;  magnesia;  solution  of  carbonate  of  soda  ; 

emollient  drinks  ;  fixed  oils  and  fatty  matter ;  plaster  off  wall,  in 

emergency. 

ACONITE. 

Symptoms.  Numbness  and  tingling  of  the  mouth  and 
throat,  followed  by  vomiting  and  purging ;  giddiness ;  feeble 
pulse  ;  dilated  pupil ;  oppressive  breathing  ;  paralysis.  Death 
occurs  from  syncope  or  apnoea. 

Antidotes.  Emetics  ;  stimulants,  external  and  internal,  such 
as  sulphate  of  zinc,  tannic  acid,  animal  charcoal,  atropine, 
belladonna. 

ALKALIES  {See  Potash). 
ANTIMONY  (  Tartar  Emetic,  Butter  of  Antiinony). 

■  Symptoms.  A  burning  pain  in  stomach  and  bowels  ;  vomit- 
ing ;  purging  ;  cold  perspiration  ;  great  thirst ;  cramps  ;  great 
debility,  and  death. 

Antidotes.  Vegetable  acids,  such  as  tannic  acid,  catechu, 
nutgalls,  white  oak  bark,  kino,  cinchona. 

ARSENIC. 

Symptoms.  Faintness  and  nausea,  with  burning  pain  in  the 
epigastrium  ;  vomiting ;  purging,  or  diarrhoea ;  thirst ;  constric- 
tion in  the  throat ;  feeble  action  of  the  heart,  with  a  quick  and 
weak  pulse  ;  painful  and  hurried  respiration  ;  cold  and  clammy 
skin.  Death  occurs  from  collapse,  and  sometimes  with  convul- 
sions. 


48  DENTAL    MEDICINE. 


Antidotes.  Moist  peroxide  of  iron  (obtained  from  perchlo- 
ride  of  iron  and  calcined  magnesia) ;  animal  charcoal  ;  ammo- 
nia ;  lime  water ;  stomach  pump  ;  artificial  respiration  ;  cold 
affusion  ;  emetics ;  milk ;  raw  eggs. 

ARGENTI  NITRAS  (^Nitrate  of  Silver). 

Symptoms.  Corrosion  of  parts;  sometimes  nausea  and  vomit- 
ing and  convulsions ;  paralysis. 

Antidotes.     Solution  of  common  salt  in  demulcent  drinks ; 

albumen. 

ATROPINE. 

Symptoms.  Insatiable  thirst,  with  dryness  of  mouth  and 
throat ;  nausea  ;  giddiness  ;  palpitation  of  heart ;  intensely 
dilated  pupil ;  coma,  and  death. 

Antidotes.     Emetics  ;    sulphate  of  copper  (gr.  x) ;    cold  to 

head ;    ammonia,  externally  and  internally ;    opium  ;    animal 

charcoal;  calabar  bean;  stimulants;  subcutaneous  injection  of 

morphia. 

BELLADONNA. 

Symptoms.     Same  as  those  of  atropia. 
Antidotes.     Same  as  for  atropia. 

CANNABIS  INDICA  [Indian  Hemp). 

Symptoms.  Temporary  insanity,  as  shown  by  a  singular 
gait,  a  constant  rubbing  of  hands,  and  other  strange  actions  ; 
a  peculiar  and  cunning  appearance  of  the  eyes ;  great  hunger. 

Antidotes.  Hot  brandy  and  water ;  vegetable  acids,  such  as 
lemon-juice,  vinegar,  etc.;  blisters  to  nape  of  neck;  indulgence 

in  sleep. 

CANTHARIDES. 

Symptoms.  A  burning  pain  in  stomach ;  vomiting  and 
purging ;  blood-stained  urine ;  pain  in  loins  ;  strangury ;  pria- 
pism ;  convulsions ;  death. 

Antidotes.  Emetics ;  emollient  or  mucilaginous  drinks ; 
opiates  by  mouth  and  rectum ;  venesection,  if  necessary. 

CARBOLIC   ACID. 
Symptoms.     When  taken  internally,  it  causes  pain  in  the 
stomach ;  a  whitened  and  shriveled  appearance  of  the  mucous 


POISONS.  49 

membrane  of  the  lips,  mouth  and  throat;  sometimes  vomiting; 
contracted  pupils ;  stertorous  breathing ;  coma,  and  death 
within  a  period  of  from  five  to  ten  minutes  to  eight  or  ten 
hours,  according  to  the  quantity  of  the  acid  swallowed. 

Antidotes.  Olive  oil ;  castor  oil ;  lime  water ;  saccharate  of 
lime;  precipitated  carbonate  of  lime;  albuminous  and  mucila- 
ginous substances. 

CHLORINE  WATER. 

Symptoms.     Irritation  of  air  passages ;  burning  pain  in  the 
throat  and  stomach ;  vomiting  of  bloody  mucus. 
Antidotes.     Albumen  ;  white  of  &^^ ;  milk  ;  flour. 

CHLORAL. 

Symptoms.  Excitement ;  delirium  ;  flushed  face  ;  cramps  in 
limbs;  eyes  closed;  profound  unconsciousness;  stertorous 
breathing ;  increasing  feebleness  ;  lividity  of  countenance ;  loss 
of  pulse  ;  pallor ;  coldness  of  extremities  ;  muscular  relaxation  ; 
death  from  cardiac  syncope. 

Antidotes.  Nitrite  of  amyl,  when  the  poison  has  been  taken 
in  large  quantity;  strychnia,  when  the  action  of  the  poison  is 
slow  and  culminative.  According  to  some  authorities,  picrotine, 
-h  gr->  sufficient  for  30  grs.  of  chloral ;  coffee. 

CHLOROFORM. 

Symptoms.  Drowsiness  ;  insensibility ;  stertorous,  rapid 
breathing ;  weak  pulse  ;  dilatation  of  pupils ;  relaxation  of 
muscles  ;  coldness  of  surface  ;  increasing  feebleness  of  pulse  ; 
heart  ceasing  its  action. 

Antidotes.  Fresh  air;  artificial  respiration  (inclining  head 
down,  tongue  pulled  forward),  cold  water  dashed  over  face  and 
chest ;  galvanism  to  pneumogastric  and  through  diaphragm 
(one  pole  may  be  applied  to  nape  of  neck  and  the  other  to  the 
pit  of  the  stomach) ;  brandy  and  ammonia  enemata  ;  hypoder- 
mic injection  of  tV  gr.  of  digitaline,  followed  in  four  hours  after 
by  To  gr.  of  atropia,  or  hypodermic  injection  of  i  drachm  of 
ether;  inhalation  of  nitrite  of  amyl;  tracheotomy. 


50  DENTAL   MEDICINE. 


CONIUM  {Hemlock). 
Symptoms.     Thirst ;    dryness    of  throat ;  delirium ;  convul- 
sions ;  coma  and  death  resulting  from  paralysis  of  the  respi- 
ratory muscles. 

Antidotes.  Emetics,  followed  by  demulcent  drinks,  internal 
and  external  stimulants,  as  brandy ;  ammonia  ;  coffee,  if  coma 
is  present ;  tannic  acid ;  animal  charcoal. 

CORROSIVE  SUBLIMATE. 

Symptoms.  Heat  and  pain  of  a  burning  nature  in  mouth, 
and  throat,  and  stomach  ;  nausea ;  vomiting  of  bloody  mucus  ; 
diarrhoea ;  dysentery ;  cramps ;  convulsions  ;  coma  and  death. 

Antidotes.  Albumen ;  milk ;  white  of  q^^  (white  of  i  egg 
to  4  grs.  corrosive  sublimate);  flour;  perchloride  of  tin  ;  iron 
and  zinc  (iron  filings  2  parts  and  zinc  i  part). 

CREASOTE     I^See  Carbolic  Acid). 
CROTON  OIL. 

Symptoms.  Irritation  of  mucous  membrane  ;  burning  pain 
along  course  of  alimentary  tract ;  excessive  purging  ;  inflamma- 
tion of  stomach  and  intestines. 

Antidotes.  Emetic  of  sulphate  of  copper,  lo  grs.,  followed 
by  mucilaginous  fluids  containing  opium,  to  allay  the  pain  ; 
olive  oil ;  opium. 

SULPHATE  OF  COPPER. 

Symptoms.  Metallic  taste ;  eructations  ;  violent  emesis  and 
purging ;  cramps  in  limbs ;  griping  pains ;  headache  ;  giddi- 
ness ;  convulsions ;  coma  and  death,  with  symptoms  of  a 
disordered  condition  of  the  nervous  system. 

Antidotes.     Albumen  or  white  of  &^%. 
DIGITALIS. 

Symptoms.  Nausea ;  vomiting ;  purging ;  feeble  or  slow  and 
irregular  pulse;  dilated  pupils;  excessive  debility;  stupor; 
convulsions  ;  coma  and  death. 

Antidotes.  Recumbent  posture  after  the  use  of  such  emetics 
as  sulphate  of  zinc ;  stimulants  internally  and  externally ;  tannic 
acid;  animal  charcoal. 


POISONS.  51 


HYDROCYANIC  ACID. 


Syniptoins.  Dilated  pupils;  spasmodic  breathing;  convul- 
sions ;  insensibility ;  fixed  eyes ;  spasmodic  closure  of  jaws ; 
very  feeble  pulse  and  speedy  death. 

Antidotes.     Fresh    air    and   artificial   respiration,  with    cold 

affusion   upon   head   and   neck ;   freshly  precipitated   oxide  of 

iron,  with  an  alkaline  carbonate,  such  as  carbonate  of  ammonia ; 

chlorine. 

HYOSCYAMUS. 

Symptoms.  A  feeling  of  giddiness,  followed  by  delirium ; 
dilated  pupils  ;  fullness  about  the  head ;  drowsiness  ;  cold  per- 
spiration ;  paralysis  ;  exhaustion  ;  death. 

Antidotes.  Stomach  pump ;  emetics ;  stimulants,  external 
and  internal ;  lemon  juice;  strong  coffee. 

IODINE. 

Symptoms.  In  extreme  cases,  violent  vomiting  and  purging; 
fever  and  excessive  thirst ;  palpitation  of  heart ;  cramps  ;  small 
and  frequent  pulse ;  occasional  dry  cough ;  and  when  death 
ensues,  it  is  probably  due  to  gastro-enteritis.  In  excessive 
doses,  it  acts  as  an  irritant  poison,  giving  rise  to  such  symptoms 
as  restlessness ;  burning  sensation ;  palpitation ;  violent  priapism ; 
frequent  pulse  ;  excessive  thirst;  extreme  diarrhoea;  trembling; 
extreme  emaciation,  and  sometimes  syncope. 

Antidotes.  Emetics  and  demulcent  drinks  ;  starch  or  flour 
diffused  in  water ;  albumen  ;  milk. 

LEAD  SALTS. 

Symptoms.  A  dry  and  constricted  throat ;  pain  in  stomach 
and  bowels ;  colic ;  paralysis  of  extensor  muscles ;  apoplectic 
symptoms. 

Antidotes.     Sulphate   or  phosphate   of  soda ;  Epsom  salts, 

followed  by  emetics,  and  afterwards  opium  and  milk ;  iodide  of 

potassium. 

MORPHINE     {See  Opium). 

MERCURY. 

When  in  the  form  of  the  perchloride  (corrosive  sublimate), 
or  nitrate  of  mercury,  see  corrosive  sublimate. 


52  DENTAL    MEDICINE. 


NUX  VOMICA. 

Symptoms.  Spasmodic  twitching  of  muscles  ;  violent  move- 
ments of  limbs ;  tetanic  spasms  ;  dyspnoea ;  death. 

Antidotes.  Enema  of  tobacco,  ^  oz.  to  20  oz.  of  boiling 
water,  to  be  administered  until  spasms  abate ;  nicotine,  i  drop, 
in  warm  sherry  wine  and  water. 

OPIUM. 

Symptoms.  Increasing  drowsiness  ;  giddiness  ;  stupor ;  in- 
sensibility ;  stertorous  breathing ;  feeble  pulse ;  contracted 
pupil ;  coma  ;  convulsions  ;  death. 

Antidotes.  Emetic  of  10  grs.  of  sulphate  of  copper ;  stomach 
pump  ;  stimulants,  external  and  internal ;  brandy  and  coffee ; 
artificial  respiration ;  cold  affusion ;  ammonia  to  nostrils ;  en- 
forced exertion  ;  galvanic  shocks ;  belladonna ;  tannic  acid  ; 
animal  charcoal ;  atropine. 

OXALIC  ACID. 

Symptoms.  Burning  pain  in  throat,  oesophagus  and  stomach ; 
vomiting  of  a  dark  green  or  black  fluid,  composed  of  altered 
mucus  and  blood. 

Antidotes.  Chalk ;  magnesia ;  plaster  from  wall  in  emer- 
gency; solution  of  carbonate  of  soda;  emetics;  stomach 
pump. 

PHOSPHORUS. 

Symptoms.  Burning  pain  along  alimentary  tract ;  corrosion 
of  tissues  ;  vomiting  of  mucus  and  blood  ;  diarrhoea. 

Antidotes.     Magnesia;  turpentine;  emetics  and  purgatives. 
POTASH  AND  SODA  SALTS. 

Symptoms.  Sharp,  burning  pain  of  the  mouth,  throat, 
oesophagus  and  stomach ;  corrosion ;  vomiting  of  blood  and 
mucus. 

Antidotes.  Dilute  acetic  acid;  citric  acid;  lemon  juice; 
fixed  oils ;  demulcents. 

SILVER     {Nitrate  of  Silver). 

Symptoms.  Corrosion  of  tissues;  nausea;  vomiting;  con- 
vulsions ;  paralysis. 


THE    PULSE.  53 


Antidotes.  Chloride  of  sodium  (common  salt)  ;  albumen  ; 
white  of  egg. 

STRAMONIUM     {See  Belladonna). 
STRYCHNINE. 

Symptoms  Spasmodic  action  of  muscles  (twitching) ;  jerking 
of  limbs  ;  tetanic  spasms  ;  dyspnoea  ;  death. 

Antidotes.  Chloroform  ;  belladonna ;  tincture  of  aconite  ; 
morphia ;  tobacco ;  chloral,  in  drachm  doses ;  8  grs.  morphia 
antidote  to  i  gr.  strychnia ;  extract  of  conium. 

TOBACCO. 

Symptoms.     Nausea ;  vomiting ;  violent  retching. 
Antidotes.     Emetic;  stimulants,  both  external  and  internal; 
strychnia. 

ZINC   SALTS. 

Symptoms.  A  burning  sensation  in  stomach  ;  nausea;  vomit- 
ing; anxious  countenance;  difficult  breathing;  small,  quick 
pulse ;  cold  perspiration  ;  syncope  ;  convulsions  ;  death. 

Antidotes.  Carbonate  of  soda ;  emetics ;  warm  demulcent 
drinks. 

THE    PULSE. 

The  word  "  pulse  "  is  derived  from  the  Latin  word  pidso, 
"  I  strike,"  and  denotes  the  striking  or  lifting  of  the  finger  by 
the  distending  vessel,  as  with  each  contraction  of  the  heart 
blood  is  forced  into  the  vessels. 

The  word  pulse  has  also  been  applied  to  the  appearance  of 
a  lifting  up  of  the  coverings  over  a  distending  vessel,  so  that 
this  word  "  pulse  "  is  applied  not  only  to  that  which  is  felt,  but 
to  that  which  is  seen. 

There  are  two  kinds  of  pulse,  the  arterial  and  the  venous. 
The  arterial  is  appreciated  mainly  by  palpitation,  the  venous 
by  inspection.  It  is  the  "  arterial  pulse  "  that  it  is  necessary 
to  study. 

The  "  radial  pulse  "  is  the  one  usually  selected,  although  the 
"  temporal  pulse  "  is  also  noted  in  the  administration  of  anaes- 
thetic agents.    The  pulse  in  other  vessels  must  also  sometimes 


54  DENTAL   MEDICINE. 

be  observed,  as  in  the  brachial,  the  facial  in  front  of  the  masseter 
muscle,  the  posterior  tibial,  the  dorsalis  pedis,  the  carotid  and 
femoral  arteries. 

The  "  radial  pulse,"  the  one  usually  selected,  and  which,  in 
most  cases,  answers  all  the  requirements,  is  of  moderate  size, 
superficial,  and  can  be  readily  compressed  against  the  radius. 

When  the  pulse  is  to  be  observed,  the  patient  should  be 
either  sitting  or  lying  down.  The  observer  should  place  his 
index,  middle,  or  ring  finger  lightly  upon  the  pulse,  and  should 
then  appreciate  the  state  of  the  coats  of  the  artery,  and  should 
next  note  the  frequency,  the  rhythm,  the  tension,  volume  and 
force  of  the  pulse ;  and,  lastly,  any  peculiarities,  if  present. 
Moreover,  the  pulse  of  one  side  of  the  body  should  always  be 
compared  with  the  other. 

It  should  also  be  remembered  that  forcible  extension  or 
flexion  of  the  forearm  will  sometimes  arrest  the  radial  pulse. 

In  noting  the  pulse  of  children  and  infants,  it  is  well  to 
count  the  pulse,  if  possible,  while  they  are  asleep. 

This  can  be  conveniently  done  in  the  temporal  artery. 
In  noting  the  pulse  at  the  wrist,  asleep  or  awake,  there  are 
often  involuntary  movements  of  the  arm  and  twitching  of  the 
muscles,  which  render  it  difficult  to  keep  the  finger  of  the 
observer  on  the  pulse.  This  difficulty  may  be  overcome  in  a 
great  degree  by  grasping  the  entire  hand  of  the  child,  and  then 
extending  the  index  finger  upon  the  pulse.  It  is  also  advisable 
not  to  take  the  pulse  of  the  patient  until  some  little  time  has 
elapsed  after  the  appearance  of  the  observer.  In  health, 
changes  in  the  frequency  and  rhythm  of  the  pulse  are  often 
met  with. 

The  following  is  a  table  of  the  variations  in  the  frequency  of 
the  pulse  in  health  : — 

Infant  asleep,  at  birth, 140 

Infancy, 120 

Child  under  5  years  of  age, 100 

Youth, 90 

Male  adults 72-80 

Female  adults, 80-85 

Old  age, 70 


THE    PULSE.  55 


It  is  only  in  rare  cases  that  great  frequency  of  the  pulse  in 
health  is  met  with.  Sex  has  some  influence.  Up  to  the /th  year  of 
age  the  frequency  is  about  the  same  in  both  sexes,  but  later 
the  female  pulse  is  from  6  to  14  beats — average  9 — greater 
than  in  the  male. 

Posture  also  affects  the  pulse.  It  is  most  frequent  in  the 
standing,  and  least  in  the  recumbent  position. 

The  pulse  of  a  man  is  twice  as  much  affected  by  change  of 
position  as  that  of  a  woman. 

When  the  pulse  is  much  increased  in  frequency,  change  in 
position  has  but  little  effect,  and,  for  the  higher  numbers, 
entirely  disappears.  When  the  head  is  lower  than  the  body, 
the  pulse  falls.  The  general  law  as  to  the  degree  of  frequency 
of  the  pulse,  as  affected  by  position,  is  as  follows : — 

The  frequency  is  directly  proportioned  to  the  amount  of 
muscular  effort  required  to  support  the  body  in  different 
positions.  The  pulse  falls  in  sleep,  as  much  as  ten  beats. 
Sleeplessness  increases  its  frequency.  On  awaking  from 
sleep,  there  is  usually  a  decided  increase  in  frequency.  Food 
increases  the  rate  of  the  pulse.  Mental  excitement  and  activity 
of  the  emotions  increases  the  frequency;  mental  depression  is 
often  accompanied  by  a  decrease.  Cold  lowers  and  heat  raises 
the  rate  of  the  pulse.  Among  other  causes  producing  an 
increase  in  the  frequency  of  the  pulse  in  health,  are  spirituous 
and  warm  drinks,  tobacco,  diminished  atmospheric  pressure. 
Among  other  causes  producing  diminished  frequency  of  the 
pulse,  besides  those  before  mentioned,  are  fatigue,  long  continued 
rest,  debility  without  disease,  and  increased  atmospheric 
pressure. 

Occasionally  the  pulse  is  irregular  in  health,  but  when  it  is 
so,  it  is  usually  congenital.  Intermittency  is  not  infrequent  in 
health,  and  it  is  then  either  congenital  or  maybe  due  to  terror, 
anxiety,  grief,  mental  or  physical  fatigue,  and  old  age.  The 
intermittency  may  be  only  temporar)^  or  it  may  become 
permanent ;  and  if  it  becomes  ver}'  frequent,  may  be  patho- 
logical. 

A  pulse  of  90  or  more   may  be   regarded  as  a  pulse  of 


56  DENTAL   MEDICINE. 

abnormal  frequency  in  an  adult.  There  are  exceptions  to  this, 
but  they  are  rare.  If  the  pulse  is  quicker  than  the  temperature 
will  explain,  it  indicates  cardiac  weakness. 

A  pulse  that  day  by  day  progressively  increases,  the  temper- 
ature remaining  the  same,  shows  increasing  cardiac  weakness. 
In  all  febrile  diseases,  a  pulse,  in  adults,  over  120  is  serious,  and 
indicates  cardiac  weakness.  A  pulse  of  130  or  140  indicates 
great  danger;  and  with  a  pulse  at  160,  the  patient  almost 
always  dies. 

Under  the  age  of  fifteen,  any  disease  of  the  lungs  is  almost 
invariably  accompanied  by  great  frequency  of  the  pulse,  so 
that  a  pulse  of  120  to  140  would  not  be  considered  as  so 
serious  in  significance  as  if  it  occurred  in  an  older  person. 

A  pulse  of  120  in  a  strong,  robust  patient  affected  with  pneu- 
monia, indicates  some  form  of  heart  disease.  When  pneu- 
monia occurs  in  the  cachectic  or  debilitated,  the  pulse  is  usually- 
very  frequent,  often  120  to  160,  and  such  cases  usually  die. 
In  pericarditis  and  myocarditis,  there  is  great  frequency  of  the 
pulse,  especially  on  any  movement  of  the  patient — 130  to  160 — 
and  the  change  may  be  very  sudden.  In  acute  articular  rheu- 
matism, unaccompanied  by  any  heart  disease,  a  pulse  of  120 
or  more  indicates  great  danger.  In  pleuritic  effusions,  the 
pulse  may  be  very  frequent,  especially  when  there  is  displace- 
ment of  the  heart. 

RESPIRATION  AT  VARIOUS  AGES. 

At  one  year  of  age,  per  minute 35 

"  two  years  of  age,  "         "         25 

"  puberty,                   "         "         20 

"  adult  age,                "         "         18 

THERMOMETERS. 

There  are  three  different  thermometers  in  use — Fahrenheit's 
Centigrade  and  Reaumer's — each  differing  from  the  other 
with  reference  to  the  number  of  degrees  between  the  freezing 
and  boiling  points  of  water.  In  Fahrenheit's,  zero  is  placed 
at  32  degrees  below  the  freezing  point,  while  in  the  others  zero 
marks  the  freezing  point. 


ELEMENTARY    SUBSTANCES. 


57 


The  boiling  point  in  Fahrenheit's  is  placed  at  212  degrees; 
in  Centigrade  at  100,  and  in  Reaumer's  at  80. 

The  degrees  between  the  freezing  and  boiling  points  in  the 
instruments  are,  therefore,  respectively  180,  100  and  80. 

The  following  diagram  will  explain  the  variance : — 

Fahrenheit,     .     .     .     .       o         32         'j-j         122  167         212 

Centigrade,     ....     17.77     o         25  50  75         100 

Reaumer, 14.22     o         20  40  60  80 

TABLE  OF  ELEMENTARY  SUBSTANCES. 


Aluminium 
Antimony 
Arsenic  . 
Barium  . 
Ber\'llium 

(Glucinum) 

Bismuth 
Boron 
Bromine 
Cadmium 
Caesium 
Calcium 
Carbon  ^ 
Cerium  . 
Chlorine^ 
Chromium 
Cobalt    . 
Copper   . 
Didymium 
Erbium  . 
Fluorine 
Gallium  . 
Gold  .     . 
Hydrogen 
Indium   . 
Iodine     . 
Iridium  . 
Iron    .     . 
Lanthanum 
Lead 
Lithium  . 
Magnesium 
Manganese 
Mercury 


i 

Sym- 

Atomic 

Kquiva- 

bol. 

Weight. 

lent. 

Al 

27 

13-5 

Sb 

120 

120 

As 

74-9 

74-9 

Ba 

136.8 

68.4 

Be 

9 

9       i 

Bi 

210 

210 

B 

II 

II 

Br 

79.8 

79.8 

Cd 

111.8 

55-9 

Cs 

132.6 

132.6 

Ca 

40 

20 

C 

12 

6 

Ce 

141 

70.5 

CI 

35-4 

35-4 

Cr 

52.4 

26.2 

Co 

S8.Q 

29.45  1 

Cu 

63.2 

31.6    ! 

Di 

144.6 

72.3 

E 

165.9 

82.95 

J^l 

19 

19 

G 

68.8 

34-4 

Au 

196.2 

196.2 

H 

I 

I 

In 

II3-4 

56.7 

I 

126.6 

126.6 

Ir 

192.7 

96-35 

l<e 

55-9 

27.95 

La 

138.5 

138-5 

Pb 

206.5 

103.25 

Li 

7 

7 

Mg 

24 

12 

Mn 

54 

27 

Hg 

199.7 

99.85 

Elements. 


Molybdenum 

Nickel    . 

Niobium 

Nitrogen^ 

Osmium 

O.xygen* 

Palladium 

Phosphorus 

Platinum 

Potassium 

Rhodium 

Rubidium 

Ruthenium 

Scandium 

Selenium 

Silicon    . 

Silver 

Sodium  . 

Strontium 

Sulphur^ 

Tantalum 

Tellurium 

Thallium 

Thorium 

Tin    .     . 

Titanium 

Tungsten 

Uranium 

Vanadium 

Ytterbium 

Yttrium  . 

Zinc    .     . 

Zirconium 


Sym- 

Atomic 

bol. 

Weight. 

1 

Mo 

95-5 

Ni 

58 

Nb 

94 

N 

14 

Os 

198.5 

0 

16 

Pd 

105.7 

P 

31 

Pt 

194.4 

K 

39 

Rh 

104. 1 

Rb 

85-3 

Ru 

104.2 

Sc 

44 

Se 

78.8 

Si 

28 

Ag 

107.7 

Na 

23 

Sr 

87.4 

S 

32 

i'a 

182 

Te 

128 

TI 

203.7 

Th 

233 

bn 

117.7 

Ti 

48 

Tr 

183.6 

U 

238-5 

V 

51-3 

Yb 

172.7 

Y 

89.8 

Zn 

64.9 

Zr 

90 

Equiva- 
lent. 


42.75 
29 

94 
14 

99.25 
8 
52.85 

31 
97.2 

39 
52.05 

85-3 
52.1 
22 
39-4 
14 
107.7 

23 

43-7 

16 
182 

64 
203.7 
116. 5 

58.85 

24 

91.8 
119.25 

51-3 

172.7 

89.8 

32.45 

45 


•  Carbon:  11.9736.    *  Chlorine:  35.370.     ^  Nitrogen:  14.021. 
^  Sulphur:  31.984. 


Oxygen:  I5-9633- 


58 


DENTAL    MEDICINE. 


TABLE  OF  THE  SOLUBILITY  OF  CHEMICALS  IN  WATER 
AND  ALCOHOL. 

Abbreviations  :  s.  =  soluble  ;  ins.  =  insoluble  ;   sp.  =  sparingly  ;  v.  =  very  ;   aim.  =  almost ; 
\  dec.  ^decomposed. 


CHEMICALS. 


One  part  is  soluble  in : 


Acidum  arseniosum  .  .  . 
Acidum  benzoicum  .  .  . 
Acidum  boricum  .... 
Acidum  carbolicum  .  .  . 
Acidum  chromicum  .  .  . 
Acidum  citricum  .... 
Acidum  gallicum  .... 
Acidum  salicylicum  .  .  . 
Acidum  tannicum  .... 
Acidum  tartaricum .... 

Alumen 

Alumen  exsiccatum  ,  .  . 
Ammonii  carbonas .... 

Ammonii  nitras 

Ammonii  valerianas  .  .  . 
Antimonii  et  potassii  tartras 
Argenti  cyanidum  .... 
Argenti  iodidum      .... 

Argenti  nitras 

Argenti  nitras  fusus      .     .     . 

Argenti  oxidum 

Atropina 

Atropinae  sulphas  .... 
Bismuthi  subnitras  .     .     .     . 

Bromum 

Calcii  bromidum  .  .  .  . 
Calcii  carbonas  prsecipitatus 
Calcii  chloridum  .... 
Calcii  hypophosphis  .  .  . 
Calcii  phosphas  prsecipitatus 

Calx 

Camphora  monobromata 

Chloral 

Cinchonidinse  sulphas      .     . 
Cinchonina    .     .     .     .     .     . 

Cinchonins  sulphas    .     ... 

Codeina 

Creta  praeparata      .... 

Cupri  acetas 

Cupri  sulphas 

Ferri  chloridum 

Ferri  citras 


At  15°  C. 
(50°  F.) 


Parts. 

30.80 
500 

25 

20 
V.  S. 

0.75 
100 
450 

6 
0.7 

10.5 

20 

4 

0.5 
V.  s. 

}7 

ins. 

ins. 
0,8 
06 
V.  sp. 

600 
0.4 

ins. 

33 
0.7 
ins. 

1-5 
6.8 

ins. 

750 
aim.  ins. 

V.  s. 

100 
aim.  ins. 

70 

80 

ins. 

15 

2.6 
V.  s. 

8. 


Boiling. 


15 
15 

3 

V.  s. 

0.5 

3 
14 

V.  s. 

0.5 

ins. 
ins. 
dec. 
V.  s. 
V.  s. 

.  3 

ins. 

ins. 

0.1 

0.5 

V.  sp. 

35 
V.  s. 
ins. 

V.  s. 

ins. 

V.  s. 

6 

ins. 

1300 

aim.  ins. 

V.  s. 

4 
aim.  ins. 

14 

}7 
ins. 

5 

0.5 
V.  s. 
V.  s. 


At  15°  C. 

(50°  F.) 


Parts. 

sp. 

3 

15 

V.  s. 

dec. 

I 

4-5 
2.5 
0.6 
2.5 

0.3 
0.7 
dec. 
20 
V.  s. 
ins. 
ins. 
ins. 
26 

ins. 
V.  s. 

6.5 
ins. 
dec. 

I 
ins. 

8 
ins. 
ins. 
ins. 
V.  s. 
V.  s. 

71 

no 

6 
V.  s. 
ins. 

135 
ins. 
V.  s. 
ins. 


Boiling. 


Parts. 

sp. 

I 

5 
V.  s. 
dec. 

0.5 

I 
V.  s. 
V.  s. 

0.2 
ins. 
ins. 
dec. 

3 
V.  s. 
ins. 
iris, 
ins. 

5 
.  5 
ins. 
V.  s. 
V.  s. 
ins. 
dec. 
V.  s. 
ins. 

1-5 

ins. 
ins. 
ins. 
V.  s. 
V.  s. 

12 

28 
1-5 

V.  s. 
ins. 

14 
ins. 
V.  s. 
ins. 


CHEMICALS    SOLVABLE    BY   WATER    AND    ALCOHOL. 


59 


TABLE  OF  THE  SOLUBILITY  OF  CHEMICALS  IN  WATER  AND  ALCOHOL. 

(Continued.) 


CHEMICALS. 


One  part  is  soluble  in  : 

Ferri  lactas 

Ferri  sulphas 

Ferri  valerianas 

Hydrargyri  chloridum  corrosivum 
Hydrargyri  chloridum  mite  .  . 
Hydrargyri  cyanidum  .  .  .  . 
Hydrargyri  iodidum  rubrum  .  . 
Hydrargyri  iodidum  viride  .  .  . 
Hydrargyri  oxidum  flavum  . 
Hydrargyri  oxidum  rubrum  .  . 
Hydrargyrum  ammoniatum  .  . 
HyoscyaminK  sulphas      .     .     .     . 

lodoformum 

lodum 

Magnesia 

Magnesii  carbonas 

Magnesii  sulphas 

Magnesii  sulphis 

Mangani  oxidum  nigrum      .     .     . 

Mangani  sulphas 

Morphina 

Morphinae  acetas 

Morphinae  hydrochloras  .     .     ,     . 

Morphinae  sulphas 

Phosphorus 

Piperina 

Plumbi  acetas 

Plumbi  carbonas 

Plumbi  iodidum 

Plumbi  nitras 

Plumbi  oxidum 

Potassa 

Potassii  acetas 

Potassii  bicarbonas 

Potassii  bichromas 

Potassii  bitartras 

Potassii  bromidum 

Potassii  carbonas 

Potassii  chloras 

Potassii  citras 

Potassii  cyanidum 

Potassii  ferrocyanidum     .     .     .     . 
Potassii  hypophosphis       .     .     .     , 

Potassii  iodidum 

Potassii  nitras 


WATER. 

ALCOHOL. 

At  15°  C. 
(50°  F.) 

1 

Boiling. 

At  15°  C. 
(50°  F.) 

Boiling. 

Parts. 

Parts. 

Parts. 

Parts. 

40 

12 

aim.  ins. 

aim.  ins. 

1.8 

0-3 

ms. 

ins. 

ms. 

dec. 

V.  s. 

V,  s. 

16 

2 

3 

1.2 

ms. 

ms. 

ms. 

ms. 

12.8 

3 

15 

6 

aim.  ins. 

aim.  ins. 

130 

15 

aim.  ins. 

aim.  ins. 

ms. 

ins. 

ms. 

ms. 

ms. 

ms. 

ms. 

ms. 

ms. 

ms. 

ms. 

ms. 

ms. 

ins. 

V.  s. 

V.  s. 

V.  s. 

V.  s. 

ms. 

ms. 

80 

15 

sp. 

II 

aim.  ins. 

aim.  ins. 

ms. 

ms. 

aim.  ins. 

aim.  ins. 

ms. 

ins. 

0.8 

0-i5i 

ms. 

ms. 

20 

19 

ms. 

ins. 

ms. 

ms. 

ms. 

ins. 

0.7 

0.8 

ms. 

ins. 

V.  sp. 

500 

100 

36 

12 

1-5 

68 

14 

24 

0.5 

63 

31 

24 

0.75 

702 

144 

ms. 

ins. 

V.  sp. 

V.  sp. 

aim.  ins. 

aim.  ins. 

30 

I 

1.8 

0.5 

8 

I 

ms. 

ms. 

ms. 

ms. 

2000 

200 

V.  sp. 

V.  sp. 

2 

0.8 

aim.  ins. 

aim.  ins 

ins. 

ms. 

ms. 

ms. 

0.5 

V.  s. 

2 

V.  s. 

0.4 

V.  s. 

2.5 

V.  s. 

3-2 

dec. 

aim.  ins. 

aim.  ins 

10 

1-5 

ms. 

ins. 

210 

15 

V.  sp. 

V.  sp. 

1.6 

I 

200 

16 

I 

0.7 

ms. 

ins. 

16.5 

2 

V.  sp. 

V.  sp. 

0.6 

V.  s. 

V.  sp. 

V.  sp. 

2 

I 

sp. 

sp. 

4 

2 

ms. 

ms. 

0.6 

0-3 

7-3 

3-6 

0.8 

0.5 

18 

6 

4 

0.4 

aim.  ins. 

aim.  ins 

60 


DENTAL   MEDICINE. 


TABLE  OF  THE  SOLUBILITY  OF  CHEMICALS  IN  WATER  AND  ALCOHOL. 

(Continued.) 


CHEMICALS. 


One  part  is  soluble  iti : 

Potassii  permanganas  .  . 
Potassii  sulphas       .     .     .     , 

Potassii  tartras 

Quinidinae  sulphas       .     .     . 

Quinina 

Quininae  bisulphas  .  .  .  . 
Quininas  hydrochloras  .  . 
Quininae  sulphas  .  .  .  . 
Quinine  valerianas      .     .     , 

Saccharum 

Saccharum  lactis     .     .     .     . 

Salicinum -  .     ■ 

Soda . 

Sodii  acetas 

Sodii  bicarbonas      .     .     .     . 

Sodii  boras 

Sodii  carbonas 

Sodii  chloras 

Sodii  chloridum  .  .  .  .  , 
Sodii  hypophosphis  .  .  , 
Sodii  hyposulphis  .  .  .  , 
Sodii  iodidum      .     .     .     .     , 

Sodii  nitras 

Sodii  sulphas       .... 

Sodii  sulphis 

Strychnina 

Strychninse  sulphas     .     . 
Sulphur  lotum     .... 
Sulphur  praecipitatum 
Sulphur  sublimatum    .     .     , 

Thymol 

Veratrina 

Zinci  acetas 

Zinci  carbonas  prascipitatus 
Zinci  chloridum  .  .  . 
Zinci  iodidum  .... 
Zinci  oxidum  .... 
Zinci  phosphidum  .  .  . 
Zinci  sulphas  .... 
Zinci  valerianas  .... 


At  15°  C. 
(50°  F.) 


Parts. 

20 

9 

0.7 
100 
1600 
10 

34 
740 
100 
0.5 

7 
28 

17 
3 

12 

16 
1.6 
I.I 
2.^ 
I 

1-5 
0.6 

1-3 

2.8 

4 

6700 

10 

ins. 

ins. 

ins. 

1200 

V.  sp. 

3 
ins. 
V.  s. 


V.  s. 
ins.  . 
ins. 
0.6 
100 


Boiling. 


Parts. 

3 
4 
0.5 

7 
700 
V.  s. 

I 

30 
40 

0.2 
I 

0.7 
0.8 

I 

dec. 
0.5 
0.25 
0.5 
2.5 
0.12 
0.5 

0-3 
0.6 
0.4 
0.9 
25000 
2 

ins. 

ins. 

ins. 

900 
V.  sp. 

ins. 
V.  s. 
V.  s. 
ins. 
ins. 
0-3 


ALCOHOL. 


At  15°  C. 

(50°  F.) 


dec. 

ins. 

aim.  ins. 


6 

32 

3 

65 

5 

175 

ins. 

30 

V.  s. 

.30 
ins. 
ins. 
ins. 
40 
aim.  ins. 

30 
ins. 
1.8 
sp. 
ins. 
sp. 
no 

60 

ins. 
ins. 
ins. 

I 

3 
30 
ins. 
V.  s. 
V.  s. 
ins. 
ins. 
ins. 
40 


Boiling. 


Parts. 

dec. 

ins. 

aim.  ins. 

V.  s. 

2 
V.  s. 
V.  s. 

3 
I 

28 
ins. 

2 
V.  s. 

2 
ins. 
ins. 
ins. 

43. 
aim.  ins. 

I 
ins. 

1.4 
40 
ins. 
sp. 
12 

2 
ins. 
ins. 
ins. 
V.  s. 
V.  s. 

3 
ins. 
V.  s. 
V.  s. 
ins. 
ins. 
ins. 


REMEDIAL   AGENTS.  61 


CLASSIFICATION  OF  MEDICINAL  SUBSTANCES. 

In  order  to  impress  the  memory  and  facilitate  investigation, 
it  is  necessary  that  medicinal  substances  should  be  classified 
according  to  their  similarity  of  action  on  the  animal  economy, 
as  follows  : — 

Narcotics, 

Anaesthetics, 

Antispasmodics, 

Tonics, 

Astringents, 

Stimulants, 

Sedatives, 

Spinants. 

Emetics, 

2.  EccRiTics,  or  those  which  have  a  special   I   Cathartics, 

,.  ,1  ,•  T-       i  1  •  J    Diaphoretics, 

action    on   the  secretions,      io  this  group  <   diuretics 


Neurotics,  or  those  which  have  a  special 
action  on  and  modify  the  functions  of  the  ^ 
nervous  system.     To  this  group  belong : 


Diuretics, 
belong  :  I    Blennorrhetics, 

^  Emmenagogues. 

3.  H^METics,   or    those    which    modify    the       Hsematinics, 
blood.     To  this  group  belong :  |  Antacids.  ' 

r  Irritants, 
rr-  T^     ^1  •  1     1  j    Demulcents, 

4.  Topical  remedies.    1  o  this  group  belong :  <   coloring  Agents, 

(^  Anthelmintics. 

DEFINITIONS  OF  THE  VARIOUS   CLASSES  OF 
REMEDIAL  AGENTS. 

NARCOTICS. 

Narcotics  are  medicinal  substances  which  affect  the  cerebral 
and  spinal  functions  by  impairing  or  destroying  nervous  ac- 
tion, having  first  a  stimulant  effect,  to  which  their  therapeutic 
efficacy  is  in  a  great  degree  due.  Narcotics  allay  cerebral  or 
spinal  irritability,  relieve  muscular  spasm,  and  also  pain,  and 
induce  sleep.  When  administered  to  relieve  pain,  they  are 
termed  anodynes  ;  to  induce  sleep  they  are  termed  hypnotics  or 
soporifics. 

Narcotics  fulfill  two  indications,  namely :  Exciting  and  de- 
pressing the  nervous  energy.  For  the  first,  it  is  necessary  to 
begin  with  small  doses  and  repeat  them  frequently ;  for  the 
second,  a  full  dose  must  be  given  and  not  repeated  for  a  con- 


62  DENTAL    MEDICINE. 


siderable  time.  On  account  of  the  system  becoming  very  soon 
habituated  to  the  action  of  narcotics,  when  it  is  necessary  to 
resort  to  their  use  for  any  length  of  time,  the  amount  must  be 
constantly  increased,  in  order  to  maintain  the  same  impression. 
The  difference  between  the  susceptibility  to  their  action  when 
the  body  is  in  a  morbid  or  a  healthy  condition,  should  not  be 
overlooked. 

Under  narcotics  are  classed  such  agents  as  opium  and  its 
different  preparations,  chloral,  lactucarium,  belladonna,  stramo- 
nium, hyoscyamus,  tobacco,  lobelia,  conium,  aconite,  cannabis 
indica,  humulus,  camphor,  hydrocyanic  acid,  etc.,  etc. 

ANESTHETICS. 

Anaesthetics  are  medicinal  agents  which  diminish  sensibility 
and  relieve  pain.  They  are  generally  in  the  form  of  vapors  or 
gases,  applied  by  inhalation,  and  possess  the  power  of  tempor- 
arily suspending  the  general  sensibility,  being  commonly 
employed  for  the  prevention  of  pain  during  surgical  operations. 
They  are  divided  into  general  and  local  anaesthetics. 

General  anaesthetics  are  agents  capable  of  producing  com- 
plete insensibility  throughout  the  entire  system.  Included  in 
this  class  are  such  agents  as  ether,  chloroform,  nitrous  oxide 
gas,  bromide  of  ethyl,  bichloride  of  methylene,  tetrachloride 
of  carbon,  dichloride  of  ethidene,  etc.,  etc. 

Local  anaesthetics  are  agents  whose  action  is  limited  to  a 
certain  part  or  organ,  when  topically  applied,  paralyzing  the 
nerves  of  the  part,  and  temporarily  destroying  the  sensibility. 
Included  in  this  class  are  such  agents  as  absolute  ether, 
rhigolene,  aconite,  pyrethrum,  atropine,  etc.,  etc. 

ANTISPASMODICS. 

Antispasmodics  are  medicinal  agents  which  allay  irregular 
muscular  contraction  or  spasm,  and  compose  the  irregular 
actions  of  the  nervous  system,  without  any  special  or  decided 
effect  on  the  brain.  They  are  employed  in  many  varieties  of 
mental  disturbance,  insanity,  wakefulness,  hypochondriasis, 
convulsions  from  teething,  spasm  from  general  debility,  in  which 
latter  case  an  aromatic  stimulant   of  the    circulation  and  a 


REMEDIAL    AGENTS,  63 


permanent  tonic  prove  beneficial.  In  hysteria,  dependent  upon 
idiopathic  or  primary  nervous  irritation,  the  use  of  antispas- 
modics is  indicated.  Included  in  this  class  are  such  agents  as 
asafoetida,  musk,  camphor,  valerian,  galbanum,  ammoniac,  castor, 
compound  spirit  of  ether  (Hoffman's  anodyne),  etc.,  etc. 

TONICS. 

Tonics  are  medicinal  agents  which  impart  strength  to  the 
system,  producing  a  gradual  and  permanent  increase  of  nervous 
vigor,  without  preternatural  excitement.  They  stimulate  also 
in  a  secondary  manner,  by  gradually  increasing  the  force  of 
the  circulation,  and  restoring  the  digestive  and  secretory  func- 
tions to  a  more  healthy  state,  differing,  however,  from  stimulants, 
in  the  more  permanent  character  of  their  effects. 

Certain  agents  of  this  class,  when  administered  in  large 
doses,  act  as  antiperiodics  in  intermittent  diseases.  Benefit  also 
results  in  the  use  of  tonics  by  alternating  them.  They  are 
divided  into  vegetable  and  miiteral  tonics,  the  former  possessing 
a  bitter  extractive  principle,  and  the  latter  uniting  astringent 
with  tonic  properties,  and,  in  the  case  of  preparations  of  iron, 
increasing  the  red  coloring  matter  of  the  blood.  Such  agents 
as  gentian,  quassia,  columbo,  wild  cherry,  serpentaria,  cinchona 
and  its  alkaloid  quinine,  salix,  pepsin,  are  examples  of  vegetable 
tonics ;  and  the  preparations  of  iron,  preparations  of  copper, 
preparations  of  zinc,  and  such  agents  as  subnitrate  of  bismuth, 
sulphuric,  nitric,  muriatic  and  oxalic  acids,  are  examples  of 
the  mineral  tonics. 

ASTRINGENTS. 

Astringents  are  medicinal  agents  which  produce  contraction 
of  the  tissues,  having  a  corrugating  power,  either  directly 
exerted  on  a  part,  or  extended  by  sympathetic  action,  and  thus 
removing  morbid  affections  arising  from  a  state  of  relaxation, 
such  as  inflammation  of  superficial  parts,  hemorrhage  and 
excessive  discharges  from  mucous  membranes.  This  class  of 
remedies  is  important  in  dental  practice,  owing  to  their  great 
efficacy  as  antiphlogistics.  Astringents  are  divided  into  vegetable 
and    mineral,  the   former   owing   their  peculiar   property    of 


64  DENTAL    MEDICINE. 


astringency  to  the  presence  of  tannic  acid,  while  the  latter 
possess  a  more  decided  astringency,  and  exert  a  sedative  action 
on  the  vascular  system.  In  the  treatment  of  affections  of  the 
mucous  membrane,  such  as  stomatitis,  the  object  is  to  arrest  the 
inflammatory  action,  which  is  accomplished  by  the  power  of 
the  astringent  remedies  employed  locally  to  increase  the  toni- 
city of  the  tissue,  and  to  diminish  the  calibre  of  the  vessels 
supplying  the  part  with  blood,  thus  diminishing  the  quantity 
required  for  the  production  of  the  morbid  action.  Besides 
diminishing  the  current  of  the  blood  to  the  inflamed  part, 
astringents  also  exert  an  influence  on  the  pores  or  ducts 
through  which  the  discharge  is  poured  out,  by  diminishing 
their  calibre  also.  Astringents  also  exert  an  influence  on 
morbidly  relaxed  tissues,  when  such  a  condition  results  as 
the  sequelae  of  disease,  especially  in  lymphatic  temperaments, 
where  flabbiness  of  the  soft  tissues  is  characteristic. 

Care,  however,  is  necessary  in  the  use  of  astringents,  for 
when  long  or  immoderately  used  they  may  act  as  direct  irri- 
tants, inducing  inflammation  followed  by  ulceration  and  slough- 
ing. They  are  contra-indicated  for  the  arrest  of  evacuations 
that  are  designed  by  nature  to  relieve  a  plethoric  state  of  the 
system,  unless  such  evacuations  exist  to  an  alarming  extent. 
This  class  of  remedies  can  be  readily  detected  by  the  taste,  as 
they  convey  a  sense  of  roughness  to  the  palate  which  cannot 
be  mistaken,  and  which  is  more  marked  in  some  substances 
than  in  others.  Such  agents  as  tannic  acid,  gallic  acid,  nut- 
gall,  matico,  kino,  catechu,  rhatany,  white  oak  bark,  creasote, 
salicylic  acid,  are  examples  of  the  vegetable  astringents ;  while 
the  preparations  of  iron  and  lead,  alum,  sulphuric  and  nitric 
acids  are  examples  of  the  mineral  astringents.     (See  Styptics) 

STIMULANTS. 

Stimulants,  also  known  as  excitants  and  hypersthenics,  are 
medicinal  substances  capable  of  exciting  a  temporary  and 
rapid  exaltation  of  the  organic  actions,  the  excitation  thus  pro- 
duced being  extended  or  not  to  the  rest  of  the  system.  Al- 
though the  stomach  is  the  organ  generally  selected  in  medical 


REMEDIAL   AGENTS.  65 


practice  to  be  the  first  impressed  by  stimulants,  on  account  of 
the  extensive  sympathy  which  exists  between,  it  and  the  rest  of 
the  system,  in  dental  practice  these  agents  are  topically  applied 
to  the  mucous  membrane  of  the  mouth  as  counter-irritants 
and  vesicants.  The  influence  of  stimulants  is  most  apparent 
in  conditions  of  morbid  depression,  whereas  in  health  they 
soon  induce  depression.  They  possess  the  power  of  arousing 
the  energies  of  the  nervous  system,  and  hence  are  beneficial  in 
many  nervous  disorders,  especially  those  of  a  spasmodic  na- 
ture. When  applied  to  the  gastro-intestinal  canal  they  pro- 
mote digestion  as  stomachics,  and  when  administered  to  dispel 
flatulence  they  are  known  as  camninatives.  When  internally 
administered,  it  is  for  the  most  part  advisable  to  begin  with 
small  doses,  and  increase  them  as  circumstances  may  require. 
In  some  cases,  however,  it  is  necessary  to  give  them  freely 
from  the  first.  It  is  often  requisite  to  change  the  stimulating 
substance  and  also  the  part  of  the  body  to  which  it  is  ap- 
plied; when  the  stomach  fails,  the  rectum  and  skin  may  be 
acted  upon  beneficially.  Topically  applied,  stimulants  irritate 
and  inflame  the  parts  with  which  they  come  in  contact,  and 
are  then  known  as  irritants. 

The  most  powerful  and  rapid  stimulants  are  known  as  dif- 
fusible, while  those  of  a  vegetable  nature,  containing  a  volatile 
oil,  are  termed  aromatic.  Among  the  class  of  diffusible  stimu- 
lants are  such  agents  as  alcohol,  preparations  of  ammonia, 
arnica,  phosphorus,  etc.,  etc.  Among  the  class  of  aromatic 
stimulants  are  capsicum,  cinnamon,  black  pepper,  mace,  cloves, 
pimento,  oil  of  turpentine,  ginger,  cardamom,  calamus,  gaul- 
theria,  peppermint,  origanum,  etc.,  etc. 

SEDATIVES. 

Sedatives  are  medicinal  substances  employed  to  diminish 
the  frequency  of  the  action  of  the  circulation,  their  therapeutic 
influence  being  due,  it  is  thought,  to  a  stimulant  character. 
They  reduce,  vascular  excitement,  and  while  relieving  irrita- 
bility and  irregularity  of  the  heart's  action,  their  first  effect  is  to 
restore  its  tone  and  force  when  it  is  in  a  morbidly  depressed 


66  DENTAL    MEDICINE. 


condition.  Substances  known  as  refrigerants ^  which  possess 
the  power  of  dim-inishing  febrile  heat,  allaying  thirst,  restoring 
the  secretions,  and  which  comprise  almost  all  of  the  neutral 
alkaline  salts,  are  also  included  with  sedatives.  Among  the 
class  known  as  sedatives  are  digitalis,  American  hellebore 
(veratrum  viride),  white  hellebore  (veratrum  album),  yellow 
jasmine  (gelsemium),  tartar  emetic,  nitrate  of  potassium,  etc., 
etc.  Among  the  class  known  as  refrigerants  are  borate  of 
soda,  citrate  of  potassium,  acetate  of  ammonia,  spirit  nitrous 
ether,  and  vegetable  acids. 

SPINANTS. 

Spinants  or  spastics  are  medicinal  substances  employed  to 
excite  muscular  contraction.  Vegetable  spinants  containing 
the  alkaloids  strychnia  and  brucia  and  employed  therapeuti- 
cally in  cases  of  torpid  and  paralytic  conditions  of  the  mus- 
cular system,  are  the  most  important  of  this  class ;  also  ergot, 
which  is  employed  to  excite  muscular  contraction  of  the  uterus. 
Among  the  class  of  spinants  are  such  agents  as  nux  vomica, 
and  its  alkaloid  strychnine,  ignatia,  cotton-root  bark,  ergot. 

EMETICS. 

Emetics  are  medicinal  substances  which  excite  vomiting, 
their  action  being  independent  of  any  effect  arising  from  the 
quantity  of  the  agent  introduced  into  the  stomach. 

While  the  action  of  an  emetic  is  local  as  regards  the  stomach, 
it  extends  to  almost  every  organ  of  the  body,  and  in  order  that 
a  substance  of  this  kind  shall  produce  its  effect  upon  the 
stomach,  it  must  first  make  an  impression  upon  the  cerebro- 
spinal axis.  Within  fifteen  or  twenty  minutes  after  an  emetic  is 
administered  there  is  experienced  a  feeling  of  distress,  relaxation 
and  faintness,  with  a  cool,  moist  skin  and  small,  feeble  and  irregu- 
larpulse,  such  symptoms  increasing  until  emesis  occurs  ;  during 
which  the  face  becomes  flushed,  the  pulse  full  and  frequent, 
with  an  increase  in  the  temperature  of  the  body.  When  the 
act  of  vomiting  is  over,  the  skin  again  becomes  moist,  the 
pulse  soft  and  feeble,  and  a  languid  and  drowsy  feeling  is  ex- 
perienced.   Whatever  may  be  the  apparent  necessity  for  evacu- 


REMEDIAL    AGENTS.  67 


ating  the  stomach,  all  the  circumstances  of  the  case  must  be 
considered,  and,  especially  if  there  be  much  arterial  excitement 
with  determination  to  the  head,  blood-letting  should  sometimes 
be  premised. 

When  the  full  dose  of  an  emetic  is  requisite,  as  in  cases  of 
poisoning,  the  object  is  to  evacuate  the  contents  of  the  stomach 
as  speedily  as  possible ;  but  in  other  cases  it  is  better  to 
administer  the  emetic  substance  in  divided  doses,  frequently 
repeated,  until  the  desired  effect  is  produced. 

In  cases  of  torpor  or  congestion,  it  is  sometimes  necessary 
to  arouse  the  system  by  retching  or  vomiting,  which  may  be 
done  by  administering  the  emetic  with  only  a  small  quantit}'  of 
fluid  ;  but  when  the  object  is  to  empty  the  stomach  and  duo- 
denum merely,  free  draughts  of  tepid  water  or  weak  chamomile 
tea  may  be  given  as  soon  as  nausea  occurs.  When  the  excita- 
bility of  the  stomach  is  greatly  diminished  by  a  narcotic,  as 
in  cases  of  poisoning,  it  is  necessary  to  assist  the  emetic  by 
the  addition  of  some  excitant.  Vinegar,  mustard,  or  ammonia 
answer  as  excitants,  when  such  an  effect  is  caused  by  opium ; 
but  the  stomach  tube  is  the  best  resource. 

There  are  some  few  cases  where  emetics  cannot  be  employed 
with  safet}-,  as  in  congestion  of  the  brain,  a  great  determination 
of  blood  to  the  head  depending  upon  constitutional  causes,  preg- 
nancy, hernia,  active  hemorrhage  from  the  lungs  and  uterus, 
acute  gastritis,  etc.,  etc. ;  and  if  emetics  are  allowable  in  such 
diseases  or  conditions,  it  is  in  nauseating  doses  only.  When 
they  are  used  merely  to  excite  nausea,  they  are  termed  iiauseants. 

Emetics,  by  frequent  use,  are  prone  to  cause  an  increased 
susceptibility  of  the  stomach  to  their  action ;  hence,  persons  ot 
delicate  habits  should  use  them  cautiously. 

Therapeutically,  emetics  are  employed  to  evacuate  the 
stomach  in  cases  of  poisoning,  undigested  food,  etc. ;  to  expel 
foreign  substances  from  the  throat  or  oesophagus ;  to  excite 
nausea,  in  order  to  depress  the  vascular  and  muscular  systems  ; 
to  relieve  spasm ;  to  promote  secretion  and  excretion  ;  and  to 
make  decided  impressions  in  the  forming  stages  of  certain  fevers 
and  delirium  tremens. 


68  DENTAL    MEDICINE. 


To  relieve  excessive  vomiting,  resulting  from  the  use  of 
emetics,  ice  broken  in  small  pieces  and  swallowed ;  lime  water 
and  milk  (a  teaspoonful  of  each,  mixed  cold,  and  given  at 
intervals  of  15  or  20  minutes) ;  a  drop  of  creasote  in  a  wine- 
glass of  cold  water  (a  teaspoonful  given  every  15  or  20  minutes) ; 
yi  drop  of  diluted  hydrocyanic  acid  in  syrup  and  water,  or  in 
syrup  of  wild  cherry  bark  (given  every  1 5  minutes) ;  or 
infusion  of  camphor  (made  with  boiling  water  and  given  cold, 
a  teaspoonful  frequently  repeated) ;  brandy  and  water ;  clove 
or  green  tea;  an  anodyne  injection;  counter  irritation  to  the 
stomach  (as  a  mustard  plaster,  or  hot  fomentation  of  brandy 
and  clove  or  spice  plaster). 

Among  the  class  of  vegetable  emetics  are  ipecacuanha, 
sanguinaria,  mustard,  lobelia,  tobacco,  squill ;  and  such  mineral 
emetics  as  sulphate  of  zinc,  sulphate  of  copper,  tartar  emetic, 
alum,  common  salt,  turpeth  mineral. 

CATHARTICS. 

Cathartics  or  purgatives  are  medicinal  agents  which  evacu- 
ate the  bowels,  and  are  capable  of  fulfilling  three  different  in- 
dications :  I.  Simply  to  evacuate  the  bowels.  2.  To  excite 
an  increased  discharge  from  the  mucous  coat  of  the  intestines, 
and  3.  To  stimulate  the  neighboring  viscera  and  cause  them 
to  secrete  a  greater  quantity  of  their  peculiar  fluids.  When 
they  produce  watery  discharges  by  stimulating  the  mucous 
follicles  and  exhalants,  they  are  termed  hydragogiies.  When 
given  in  overdoses  they  are  so  powerful  as  to  produce  violent 
vomiting  and  purging,  pain  in  the  abdomen,  cold  extremities 
and  a  sinking  pulse.  Several  different  cathartics  are  usually 
combined  in  one  formula,  when  it  is  desired  to  produce  all  of 
the  indications  above  referred  to.  Some  agents  of  this  class 
produce  their  effect  by  absorbing  the  acid  generated  in  the 
alimentary  canal,  thus  becoming  converted  into  a  purgative 
salt,  as  magnesia,  for  example.  Others  expend  their  principal 
force  upon  the  rectum  and  large  intestines,  and  for  this  reason 
are  advantageously  employed  in  affections  of  the  lower  bowels, 
and  the  uterus  and  its  appendages,  such,  as  aloes,  for  example. 


REMEDIAL   AGENTS.  69 


Cathartics  should  always  be  given  on  an  empty  stomach.  If 
administered  immediately  after  a  full  meal,  they  arrest  the  di- 
gestive process,  are  liable  to  cause  nausea,  if  not  vomiting,  and 
do  not  evacuate  the  bowels  with  the  same  certainty  or  effect. 

When  simple  costiveness  is  to  be  removed,  the  cathartic 
may  be  administered  in  the  evening,  and,  if  not  sufficient,  the 
dose  can  be  repeated  in  the  morning  and  at  regular  intervals 
through  the  day,  until  the  effect  is  produced. 

In  administering  cathartics,  the  excitement  is  to  be  repeated 
till  the  requisite  action  is  induced,  yet  not  sufficient  to  prove 
an  irritant.  But  in  the  treatment  of  many  diseases,  it  is 
preferable  to  purge  through  the  day,  in  order  that  the  sleep 
may  not  be  disturbed  at  night.  The  operation  of  cathartics 
may  be  very  much  accelerated  by  the  free  use  of  diluent 
drinks,  such  as  gruel,  barley  water,  etc.,  etc.  By  combining 
these  remedies,  the  action  of  many  of  them  is  modified  and 
controlled  ;  and  some  of  the  more  powerful  may  be  made  to 
operate  mildly  and  certainly  by  uniting  small  quantities  of 
several  of  them  in  the  same  dose. 

The  addition  of  an  emetic  substance,  such  as  ipecachuana, 
or  tartar  emetic,  gives  activity  to  the  combination,  while  it 
modifies  the  harshness  of  the  powerful  cathartics. 

The  operation  of  a  cathartic  may  often  be  promoted  by 
judicious  venesection,  and  if  there  is  spasm  of  the  intestines, 
opium  may  be  advantageously  added  to  the  cathartic. 

Cathartics  act  not  only  upon  the  bowels,  but  upon  distant 
parts,  as  every  portion  of  the  organism  is  capable  of  being 
impressed  by  them.  Cathartics  are  divided,  according  to  the 
intensity  of  their  operation,  into  laxatives,  pjirgatives  and 
drastics,  to  which  may  also  be  added  enemata.  Laxatives 
gently  stimulate  the  mucous  coat  of  the  intestines,  and  hence 
they  are  well  adapted  for  cases  in  which  the  sole  indication  is 
to  unload  the  bowels  of  their  contents.  Purgatives  are  more 
powerful  in  their  operation ;  they  excite  a  copious  exhalation 
from  the  mucous  lining  of  the  intestines,  and  augment  the 
peristaltic  action  to  a  greater  degree.  Drastics  are  the  more 
powerful  and  violent  cathartics,  and  produce  a  greater  degree 


70  DENTAL   MEDICINE. 


of  irritation  in  the  lining  membrane  of  the  intestines,  and 
occasionally  act  upon  the  nerves  of  the  stomach,  so  as  to  cause 
nausea  and  sometimes  vomiting.  Drastics  generally  belong  to 
the  resino-extractive  substances,  and  act  violently,  on  account 
of  being  sparingly  soluble  and  adhering  to  the  mucous  coat  of 
the  intestines. 

Enemata  are  agents  of  this  class  which  act  on  the  lower  part 
of  the  intestinal  tube  by  direct  application ;  they  irritate  the 
lining  membrane  of  the  rectum,  and  by  sympathy  of  continuity, 
their  influence  is  extended  to  the  intestinal  canal.  Hence 
enemata  may  be  employed  with  advantage  when  cathartics 
cannot  be  given  by  the  mouth,  as  when  deglutition  is  im- 
practicable. What  are  known  as  saline  cathm^tics  are  employed 
in  the  treatment  of  febrile  and  inflammatory  affections,  as  they 
do  not  produce  any  excitant  action  on  the  general  system. 
There  are  also  acrid  cathartics,  which  are  not  violent  enough 
to  cause  inflamma,tion.  Others  are  known  as  mercurial  ca- 
thartics. The  class  known  as  laxatives  comprise  such  sub- 
stances as  certain  articles  of  diet,  as  ripe  and  dried  fruits,  such 
as  tamarinds,  peaches,  raisins,  figs,  prunes,  also  molasses,  honey, 
cracked  wheat,  Indian  meal  and  oat  meal,  etc.,  etc.  Other 
laxatives  are  castor  oil,  manna,  sulphur,  purging  cassia,  etc., 
etc.  Saline  catliartics  comprise  such  substances  as  magnesia, 
carbonate  and  sulphate  of  magnesia  (Epsom  salts),  solution  of 
citrate  of  magnesia,  sulphate  of  sodium  (Glauber's  salt),  sul- 
phate of  manganese,  phosphate  of  sodium,  sulphate  of  potas- 
sium, cream  of  tartar,  soluble  tartar,  Rochelle  salt.  Mild,  acrid 
cathartics  comprise  such  substances  as  rhubarb,  aloes,  senna, 
leptandra,  elder.  Drastic  cathartics  comprise  such  substances 
as  jalap,  may  apple,  scammony,  colocynth,  gamboge,  elaterium, 
croton  oil.  Mercurial  cathartics  consist  of  calomel,  blue  mass, 
mercury  with  chalk.  Enemata  consist  of  tepid  water,  flaxseed 
tea  or  other  demulcent  infusion ;  a  combination  of  a  table- 
spoonful  each  of  common  salt,  molasses  and  lard  or  olive  oil 
in  two-thirds  of  a  pint  of  warm  water,  to  which  castor  oil  or 
Epsom  salt  may  be  added  to  augment  the  cathartic  effect,  is  a 
formula  for  the  common  laxative  enema. 


REMEDIAL   AGENTS.  71 


DIAPHORETICS. 

Diaphoretics,  known  also  as  sudorifics,  are  medicinal  sub- 
stances capable  of  producing  perspiration,  or  an  increase  of 
the  cutaneous  discharge,  which  may  be  occasioned  by  the  mere 
drinking  of  a  large  quantity  of  fluid,  provided  the  temperature 
of  the  system  be  kept  up.  The  determination  of  blood  to  the 
cutaneous  vessels  by  a  warm  temperature  or  exercise  will  pro- 
duce diaphoresis,  and  the  action  of  nauseating  agents,  by  re- 
laxing the  orifices  of  the  cutaneous  vessels,  and  also  stimulants, 
by  exciting  such  vessels  to  increased  secretion,  will  have  the 
same  effect. 

The  external  application  of  heat,  friction,  etc.,  stimulates  the 
cutaneous  capillaries  and  causes  an  increased  secretion. 

Diaphoresis  may  also  be  excited  by  medicines  which  enter 
the  circulation  and  stimulate  the  cutaneous  vessels  by  contact, 
such  as  the  mercurials  and  sulphur ;  also  by  medicines  which 
act  on  the  surface  sympathetically,  through  the  medium  of  the 
stomach,  as  cold  drinks,  etc. 

Diaphoresis  may  also  be  produced  by  increasing  the  general 
action  of  the  vascular  system,  by  such  means  as  violent  exercise, 
the  warm  bath,  and  by  the  use  of  alcohol,  ammonia,  guaiacum, 
etc. ;  it  may  also  be  produced  by  the  use  of  agents  capable  of 
relaxing  the  morbidly  constricted  mouths  of  the  perspiratory 
vessels,  such  as  the  antimonials,  saline  diaphoretics,  and  by  the 
operation  of  venesection. 

Nauseating  diaphoretics  are  employed  to  produce  a  powerful 
relaxing  action  in  inflammatory  cases  not  complicated  with 
gastric  irritability,  and  for  such  effects  the  emetics  ipecacuanha 
and  the  preparations  of  antimony  are  administered. 

Refrigerant  diaphoretics  are  employed  to  produce  a  gentle 
relaxing  effect  in  allaying  febrile  excitement  and  reducing  the 
temperature  of  the  body. 

Stinudating  diapJwretics  are  employed  in  rheumatic  and 
pulmonary  affections,  after  vascular  excitement  has  been 
reduced,  and  where  the  surface  is  cool,  being  contra-indicated 
in  a  high  degree  of  inflammation.  For  such  effects,  the  diffus- 
ible  stimulants,   aromatic   substances,   and   such   narcotics   as 


72  DENTAL   MEDICINE. 


opium  and  camphor,  are  administered.  During  the  adminis- 
tration of  diaphoretics,  the  patient  should  be  confined  to  bed, 
and  when  diaphoresis  is  excited,  it  should  not  be  suddenly- 
checked.  Venesection  is  generally  resorted  to  when  there  is 
great  arterial  excitement  with  undue  heat  of  skin,  before  the 
attempt  is  made  to  administer  diaphoretics. 

Belonging  to  the  class  of  diaphoretics  are  such  agents 
as  Dover's  powder,  guaiac,  spirits  of  mindererus,  nitrate  of 
potassa,  sweet  spirit  of  nitre,  etc.,  etc. 

DIURETICS. 

Diuretics  are  medicinal  substances  which  act  upon  the 
kidneys,  and  produce  an  increased  flow  of  urine. 

Remedies  of  this  class  act  immediately  and  specially  upon 
the  kidneys,  some  reaching  these  organs  by  first  passing 
through  the  blood,  without  being  decomposed,  while  others,  on 
the  contrary,  undergo  changes  in  the  first  passages,  the  result 
of  such  changes  exciting  diuresis.  The  principal  use  of  diu- 
retics is  to  promote  the  absorption  of  dropsical  effusions.  They 
are  also  employed  to  correct  nephritic  disorders,  accompanied 
with  obstructed  secretion  in  calculi  of  the  kidneys,  ureters  and 
bladder,  and,  as  evacuants,  to  reduce  inflammation. 

Where  there  is  great  arterial  excitement,  a  judicious  use  of 
the  lancet  is  recommended,  prior  to  the  administration  of  diu- 
retics, the  patient  being  kept  cool,  to  avoid  perspiration. 

To  insure  the  full  effect  of  diuretics,  diluent  drinks  should 
be  freely  given,  and  especially  such  as  contain  some  diuretic 
substance.  Included  in  the  class  of  diuretics  are  such  agents 
as  squill,  nitre,  cubebs,  juniper,  colchicum,  erigeron,  cream  of 
tartar,  copaiba,  podophyllum,  etc.,  etc. 

BLENNORRHETICS. 

Blennorrhetics  are  medicinal  substances  which  increase  the 
secretion  of  the  mucous  membranes,  and  are  employed  in 
morbid  conditions  of  such  membranes,  in  order  to  restore  them 
to  healthy  action,  in  cases  where  their  secretion  is  deficient, 
excessive  or  abnormal  in  quality.  They  are  termed  expectorants 
when  used  to  stimulate  the  secretion  of  mucus  from  the  bron- 


REMEDIAL    AGENTS.  73 


chial  or  laryngeal  membranes,  as  in  bronchitis  and  laryngitis, 
and,  during  convalescence,  in  pneumonia.  The  oleo-resinous 
agents  of  this  class  are  employed  in  chronic  diarrhoea,  and  the 
diarrhoea  of  typhoid  fever,  such  as  oil  of  turpentine,  for  example ; 
also  in  diseases  of  the  urino-genital  mucous  membranes,  such 
as  gonorrhoea,  gleet,  leucorrhoea,  incontinence  of  urine,  cystitis, 
etc.,  etc.  Included  in  the  class  of  blennorrhetics  are  such  agents 
as  senna,  cimicifuga,  garlic,  turpentine,  squill,  copaiba,  cubebs, 
matico,  buchu,  myrrh,  benzoin,  storax,  balsam  of  Peru,  balsam 
of  tolu,  etc.,  etc. 

EMMENAGOGUES. 

Emmenagogues  are  medicinal  substances  which  promote  the 
menstrual  discharge,  or  restore  it  when  entirely  suppressed. 
The  particular  emmenagogue  required  depends  upon  the  cause 
of  the  amenorrhoea ;  for  example,  when  anemia  is  the  cause, 
the  preparations  of  iron  prove  most  effectual ;  when  from 
plethora,  blood-letting  and  cathartics  or  evacuants  are  resorted 
to.  Certain  medicinal  substances  excite  the  pelvic  circula- 
tion, and  stimulate  the  parts  in  direct  connection  with  the 
uterus,  and  thereby  increase  or  promote  the  menstrual  dis- 
charge. 

General  debility  being  the  cause  of  the  local  affection,  an 
active  administration  of  tonics,  in  connection  with  the  emmen- 
agogue required,  is  advisable. 

The  most  prominent  of  this  class  of  emmenagogues  are 
savine,  cantharides,  ergot,  cotton  root,  Seneca  snake  root, 
guaiacum,  etc.,  etc. 

H^MATINICS. 

Haematinics  are  medicinal  substances  which  increase  the 
number  of  blood  corpuscles,  or  the  amount  of  hsematin  in  the 
blood,  and  hence,  are  administered  in  such  diseases  as  are 
dependent  on  a  deficiency  of  these  elements. 

This  class  of  remedies  includes  the  preparations  of  iron  or 
chalybeates,  which   are   capable   of  causing   changes    in   the 
condition    of  the    blood,    and    also    general    and    local    tonic 
effects. 
6 


74  DENTAL   MEDICINE. 


ALTERATIVES. 

Alteratives  are  medicinal  substances  which  are  capable,  when 
administered  in  small  doses,  of  removing  morbid  structures 
and  conditions,  without  any  sensible  evacuation ;  in  other  words, 
changing,  in  some  inexplicable  and  insensible  manner,  certain 
morbid  actions  of  the  system. 

Alterative  remedies  reestablish  the  healthy  functions  of  the 
animal  economy  in  a  slow  but  decided  manner,  acting  on  the 
various  secreting  organs,  sometimes  without  any  sensible 
increase  of  the  secretions  themselves.  The  effect  of  minute 
doses  of  mercury,  iodine  and  other  substances,  upon  the  gland- 
ular apparatus,  afford  examples.  Medicinal  remedies  of  almost 
every  class  become  alteratives  by  being  administered  in  very 
small  doses,  at  intervals  of  a  few  hours ;  and  they  are  generally 
classed  with  stimulants  and  tonics,  and  some  of  them  with 
narcotics.  By  their  action  the  secretions  and  exhalations  are 
increased;  the  exudation  of  plastic  or  coagulable  lymph  is 
diminished ;  the  formation  of  false  membranes  checked ;  the 
textures  softened ;  inflammatory  action  arrested ;  and  morbid 
growths  and  deposits  are  absorbed.  Phlegmonous  inflamma- 
tion is  arrested,  and  visceral  and  glandular  enlargements  are 
dispelled.  But  if  administered  too  freely,  the  blood  may 
become  so  impoverished  as  to  interfere  with  the  functions  of 
nutrition,  and  a  marasmatic  or  cachectic  condition  be  produced, 
the  textures  being  softened,  or  even  destroyed.  Hence,  this 
class  of  remedies  should  be  carefully  administered,  and  their 
effects  be  carefully  observed.  The  chief  use  of  alteratives  is 
antiphlogistic  or  resolvent;  for  example,  the  mercurials  are 
generally  employed  in  acute  inflammation,  and  the  preparations 
of  iodine  and  bromine  in  chronic  inflammations. 

Included  in  this  class  are  the  preparations  of  mercury,  iodine, 
iodide  of  potassium,  iodoform,  bromine,  preparations  of  arsenic, 
phosphate  and  hypophosphite  of  lime,  chlorate  of  potassium, 
permanganate  of  potassium,  chlorine  water,  chlorinated  lime, 
etc.,  etc. 


REMEDIAL   AGENTS.  75 


ANTACIDS. 

Antacids  are  medicinal  substances,  capable  of  neutralizing 
acidity  of  the  blood,  the  secretions,  etc.,  by  combining  with 
the  acid  and  counteracting  it. 

The  alkalies,  alkaline  earths  and  their  carbonates  are  the 
substances  included  in  this  class,  and  the  former  are  more 
energetic  in  their  action  than  the  alkaline  earths,  such  as 
magnesia.  The  carbonates  of  these  earths  have  little  or  no 
chemical  influence  upon  the  tissues. 

This  class  of  remedies,  in  the  form  of  alkaline  preparations, 
are  administered  internally  as  antacids  in  cases  where  an 
unusual  quantity  of  acid  is  generated  in  the  stomach — a  com- 
mon symptom  of  dyspepsia,  which  is  indicated  by  acid  eruc- 
tations, violent  heartburn  and  marked  effervescence  when  a 
carbonated  alkali  is  taken ;  the  acid  in  the  stomach  laying 
hold  of  the  alkaline  base,  and  resulting  in  a  large  quantity  of 
carbonic  acid  being  driven  off 

Alkalies  are  also  employed  to  relieve  irritability  of  the 
stomach  and  check  vomiting;  also  as  antidotes  in  cases  of 
poisoning  from  acids;  also  as  antUithics,  to  neutralize  lithic 
acid  when  it  is  separated  in  unusual  quantity  by  the  urinary 
secretion ;  also  as  litJiontriptics,  or  solvents  of  calculi,  more 
particularly  lithates ;  also  employed  in  cases  of  acute  rheuma- 
tism and  gout,  to  neutralize  the  excess  of  acid  in  the  blood ; 
also  in  diabetes  mellitus,  and  to  relieve  irritability  of  the  urinary 
organs,  cutaneous  irritation,  itching  of  the  anus,  especially 
when  such  conditions  are  dependent  on  an  excess  of  acid  in 
the  system ;  and  also  as  antiplastics  and  resolvents  in  inflam- 
mation, and  as  diuretics.  As  a  general  rule,  the  administration 
of  antacids  should  be  preceded  by  an  emetic  or  cathartic,  and 
in  some  cases  both. 

When  a  permanent  effect  is  desired,  antacids  are  usually 
combined  with  tonics  and  aromatics,  and  occasionally  with 
narcotics ;  for  when  given  alone  the  relief  afforded  is  but 
transient.  To  prevent  an  irritant  and  purgative  action  on  the 
bowels,  and  also  to  facilitate  their  absorption,  antacid  prepara- 
tions are  administered  in  a  state  of  large  dilution. 


76  DENTAL    MEDICINE, 


In  dental  practice  antacids  are  also  employed  for  correcting 
acidity  of  the  fluids  of  the  mouth,  often  a  result  of  acid  eructa- 
tions from  the  stomach.  The  class  of  antacids  comprise  the 
preparations  of  potassium,  sodium,  lithium,  ammonium,  mag- 
nesium and  calcium.  The  antacids  employed  in  dental  prac- 
tice are  principally  precipitated  chalk,  lime  water,  carbonate  of 

soda,  etc. 

IRRITANTS. 

The  medicinal  substances  recognized  as  irritants  are  sub- 
divided into  rubefacie?its ,  epispastics,  suppiirants  and  escharotics. 

Rubefacients  are  agents  employed  to  redden  the  surface 
by  exciting  the  action  of  the  capillaries,  and  occasioning  an 
afflux  of  vascular  and  nervous  power  to  the  part  with  which 
they  come  in  contact ;  hence  pain  is  a  usual  consequence  of 
their  employment. 

They  are  used  for  the  same  purposes  as  blisters,  and  are 
often  a  good  substitute  for  them ;  for  example,  in  low  degrees 
of  inflammation,  as  local  anodynes,  as  general  stimulants ; 
their  efficacy  as  such  depending  upon  their  action  on  the 
capillary  circulation,  and  also  on  the  pain  they  occasion.  They 
are  especially  serviceable  in  the  coma  and  asphyxia  resulting 
from  poisons  and  drowning,  but  in  cases  of  cerebral  oppres- 
sion are  inferior  to  blisters.  Rubefacients  are  used  until  red- 
ness and  pain  occur,  and  their  persistent  application  will  cause 
vesication,  and  even  gangrene. 

In  the  class  of  rubefacients  are  included  mustard,  capsicum, 
oil  of  turpentine,  ammonia  liniment.  Burgundy  pitch,  Canada 
pitch,  ginger,  black  pepper,  garlic,  and  spice  plaster. 

Epispastics,  also  called  vesicants  and  blisters,  are  medicinal 
agents  capable  of  producing,  when  applied  to  the  skin,  inflam- 
mation followed  by  an  effusion  of  serum  beneath  the  cuticle. 
As  a  general  rule,  blisters  should  remain  on  the  surface  of 
the  skin  six  or  eight  hours  in  order  to  insure  their  full  effect. 
When  the  skin  is  very  delicate,  a  shorter  application  will 
answer  every  purpose ;  and  in  the  case  of  children  it  is  seldom 
necessary  for  them  to  remain  longer  than  three  or  four  hours. 
When  applied  to  the  scalp,  twelve  hours  are  generally  re- 


REMEDIAL   AGENTS.  77 


quired.  After  removing  a  blister,  the  usual  dressing  is  some 
non-irritating  ointment,  such  as  simple  cerate.  In  acute  dis- 
eases, blistering  ought  never  to  precede  such  means  as  have  a 
tendency  to  reduce  inflammatory  action,  and  the  application 
should  be  as  near  the  affected  part  as  possible. 

Covering  blisters  with  fine  gauze  renders  them  much  less 
irritating,  and  does  not  retard  their  operation. 

If  a  blister  is  applied  long  enough  to  redden  the  skin,  a 
simple  poultice  will  complete  the  vesication ;  and  in  the  case 
of  children  this  method  should  always  be  pursued.  When  it 
is  necessary  to  keep  the  blister  open,  weak  epispastic  or  savin 
ointment  will  prove  sufficient.  When  the  circulation  is  lan- 
guid in  the  extremities,  they  seldom  act  efficiently,  and  may 
cause  gangrene  by  exhausting  what  vitality  remains.  When 
strangury  is  produced,  the  blister  must  be  removed  after  three 
or  four  hours,  and  the  part  bathed  with  olive  oil,  or  a  poultice 
applied,  and  diluent  drinks  used ;  an  opium  suppository  or 
injection  will  prove  serviceable.  Epispastics  are  employed  as 
local  stimulants  in  the  treatment  of  inflammation ;  to  create  a 
healthy  inflammatory  action,  as  in  various  cutaneous  eruptions ; 
to  relieve  pain ;  to  destroy  morbid  associations  by  causing  a 
powerful  impression ;  to  stimulate  the  absorbing  or  secreting 
vessels  of  parts  in  the  neighborhood  of  the  affected  part ;  to 
stimulate  generally ;  to  relieve  threatened  gangrene  and  paraly- 
sis ;  to  produce  local  depletion  as  evacuants,  and  to  prepare  a 
surface  for  the  endermic  application  of  medicines. 

The  class  of  epispastics  include  such  agents  as  cantharides, 
cantharidal  collodion,  water  of  ammonia,  etc.,  etc. 

SuppuRANTS  are  medicinal  agents,  which,  when  rubbed  on 
the  skin,  cause  rubefaction,  accompanied  by  a  pustular  erup- 
tion ;  their  beneficial  effects  being  due  to  the  counter-irrita- 
tion set  up.  The  agents  of  this  class  are  generally  employed 
in  subacute  chronic  laryngeal  and  bronchial  affections,  diseases 
of  the  joints,  etc.,  etc. 

Included  as  suppurants  are  croton  oil,  antimonial  ointments, 
etc. 

EscHAROTics,  called  also  Cauterants  or  Caustics,  are  medici- 


78  DENTAL    MEDICINE. 


nal  agents  capable  of  destroying  the  structure  and  vitality  of 
the  parts  with  which  they  come  in  contact,  producing  an  eschar 
or  slough,  which  is  followed  by  inflammation  and  suppuration 
of  the  neighboring  tissues  to  such  a  degree  that  the  slough 
separates  from  the  living  parts.  The  mode  of  action  of  an 
escharotic  is  as  follows :  After  being  applied  to  the  skin,  so  as 
to  chemically  disorganize  it,  or  destroy  its  vitality,  a  new  action 
is  set  up  in  the  vessels  beneath  the  slough,  so  as  to  cause  it  to 
be  thrown  off  The  excavation  resulting  is  then  kept  open  by 
inserting  some  irritant,  which  maintains  a  copious  secretion  of 
pus  from  the  ulcerated  surface.  Escharotics  are  divided  into 
Actual  and  Potential ;  the  actual  being  fire  itself,  while  the 
potential  are  substances  which  destroy  the  living  solids,  either 
by  excessive  stimulation,  or  by  producing  a  chemical  decom- 
position. 

Iron  heated  to  a  white  heat  and  the  vioxa  (cones  or  cylin- 
ders of  inflammable  substance)  represent  the  actual  cautery ; 
and  caustic  potash,  nitrate  of  silver,  burnt  alum,  chloride  of 
zinc,  chromic,  sulphuric  and  nitric  acids,  and  the  ner\'e  or 
arsenical  paste  employed  in  dental  practice,  represent  the 
potential  cautery.  A  sub-class  is  composed  of  what  are  known 
as  Issues  and  Setoxs  :  the  blister-issue ,  where  the  skin  is  re- 
moved by  a  blister,  and  the  discharge  promoted  by  means  of 
stimulating  applications,  as  the  cantharidal  ointment,  for  ex- 
ample; also,  the  pea-issue,  where  an  incision  made  by  the 
lancet  is  kept  open  by  means  of  a  pea,  bean  or  piece  of  orris 
root.  The  Seton  is  prepared  as  follows :  A  seton  needle,  to 
which  is  attached  a  skein  of  silk,  is  passed  completely  through 
the  part  chosen  for  the  operation,  after  which  it  is  removed, 
and  the  ends  of  the  silk  left  hanging  from  the  wound.  It  is 
dressed  once  or  several  times  a  day  with  some  mild  ointment ; 
or,  if  this  is  not  sufficient  to  keep  up  the  discharge,  a  more 
stimulating  ointment  is  used.  Escharotics  are  employed  to 
destroy  morbid  growths,  warts,  polypi,  condylomata,  fungous 
granulations,  etc. ;  also  to  relieve  violent  inflammation  by  their 
substitutive  action;  to  stimulate  indolent  ulcers,  sinuses,  etc.; 
to  open  abscesses  of  the  liver  and  other  internal  viscera,  the 


REMEDIAL    AGENTS.  79 


method  of  "aspiration"  being  preferred;  to  remove  cancer, 
lupus  and  other  morbid  growths ;  to  decompose  the  virus  of 
rabid  and  venomous  animals,  and  of  chancres  and  malignant 
pustules,  and  prevent  their  absorption. 

Escharotics  include  such  agents  as  caustic  potassa,  fused 
nitrate  of  silver,  caustic  soda,  solution  of  nitrate  of  mercury, 
corrosive  chloride  of  mercury,  bichromate  of  potassium,  the 
mineral  acids,  sulphate  of  copper,  and  the  substances  before 
referred  to. 

DEMULCENTS. 

Demulcents,  also  called  Lentitives,  are  medicinal  substances 
which  soften  and  relax  the  tissues.  When  applied  to  irritated 
or  inflamed  surfaces  these  agents  diminish  the  heat,  tension 
and  pain.  They  consist  principally  of  gum  or  mucilage,  often 
combined  with  saccharine  or  farinaceous  substances,  and,  di- 
luted with  water,  form  viscid  solutions.  By  modifying  the 
acridity  of  the  secretions,  they  are  capable,  to  some  degree  at 
least,  of  relieving  irritation  in  remote  organs,  although  their 
constitutional  effects  are  chiefly  nutritive.  Demulcents  are 
employed  internally  to  protect  the  gastro-enteric  surface  from 
irritating  substances,  especially  poisons  of  an  acrid  nature ; 
also  to  relieve  irritation  and  inflammation  of  the  alimentary 
canal  in  such  affections  as  diarrhoea,  dysentery,  enteritis,  gas- 
tritis, etc. ;  also  in  catarrhal  affections,  for  their  soothing  and 
lubricating  effects  from  direct  contact,  and  also  by  reflex  action ; 
and  they  also  exert  some  influence  in  modifying  the  acridity  of 
expectorated  matters ;  also  in  such  affections  of  the  urinary 
passages  as  cystitis,  ardor  urinae,  as  they  tend  to  diminish  the 
acridity  of  the  secretions ;  also  as  drinks,  to  promote  the  action 
of  the  secreting  and  exhaling  organs,  and  to  allay  the  thirst  in 
fevers;  also  as  light  diet,  and  to  suspend  substances  insoluble 
in  water. 

Demulcents  are  employed  externally  in  the  form  known  as 
Einollients,  to  relieve  the  heat,  swelling  and  pain  of  inflam- 
mation, wounds  and  burns ;  to  hasten  suppuration,  as  deter- 
gents to  cleanse  foul  ulcers,  and  to  promote  suppuration  from 
granulating  surfaces.     Mixed  with  water  in  the  form  of  soft 


80  DENTAL    MEDICINE. 


masses,  they  are  commonly  termed  cataplasms  or  poultices, 
and  have  the  effect  of  softening  the  parts  to  which  they  are 
apphed  as  vehicles  of  heat  and  moisture.  Included  in  the 
class  of  demulcents  are  such  substances  as  gum  arable,  flax- 
seed, tragacanth,  slippery  elm  bark,  sassafras  pith,  marshmal- 
low,  benne,  quince  seed,  liquorice  root,  Iceland  moss,  Irish 
moss,  starch,  arrow  root,  tapioca,  sago,  barley,  glycerin, 
pyroxylon,  collodion,  solution  of  gutta  percha,  honey,  animal 
fats,  such  as  lard,  in  form  of  cerate  (lard,  2  parts,  and  white 
wax,  I  part),  and  suet,  both  containing  stearine. 

ANTHELMINTICS. 

Anthelmintics,  or  Vermifuges,  are  medicinal  substances  em- 
ployed to  destroy  and  expel  worms  (entozoa)  from  the  ali- 
mentary canal.  Their  action  differs  according  to  the  nature 
of  the  substance  used,  either  to  destroy  by  a  direct  poisonous 
influence  or  by  mechanical  means.  The  most  powerful  of  the 
cathartics  (drastic)  also  act  as  anthelmintics  by  the  copious 
secretion  and  exhalation  which  they  produce  from  the  ali- 
mentary canal.  When  anthelmintics  are  employed,  they  must 
be  persevered  in  for  several  days,  with  the  occasional  interven- 
tion of  an  active  cathartic. 

Belonging  to  this  class  are  such  agents  as  wormseed,  spige- 
lia,  santonica,  cowhage,  male  fern,  oil  of  turpentine,  kameela, 
pumpkin  seed,  kousso,  calomel  with  gamboge,  calomel  with 
pink  root,  iron  preparations,  etc.,  etc. 

COLORING  AGENTS. 

Coloring  agents  are  substances  employed  to  communicate 
their  peculiar  color  to  pharmaceutical  preparations.  They 
include  saffron,  cochineal,  red  saunders,  etc.,  etc. ;  and  in  dental 
practice,  for  coloring  dentifrices,  rose  pink. 


In  addition  to  the  general  classes  mentioned,  there  are  cer- 
tain sub-classes  recognized,  which  have  not  been  specially 
referred  to  in  the  preceding  definitions,  as  follows : — 


REMEDIAL    AGENTS. 


81 


Absorbents, 

Anodynes, 

Antemetics, 

Anthridrotics, 

Antiperiodics, 

Antiseptics, 

Carminatives, 

Caustics, 

Cauterants, 

Constringents, 

Counter-irritants, 

Desiccatives, 

Detergents, 


Deodorizers, 

Diluents, 

Discutients, 

Disinfectants, 

Emollients, 

Errhines, 

Escharotics, 

Expectorants, 

Evacuants, 

Excitants, 

Febrifuges, 

Haemostatics, 

Hypersthenics, 

ABSORBENTS. 


Hypnotics, 

Laxatives, 

Nervines, 

Nutritives, 

Purgatives, 

Refrigerants, 

Resolvents, 

Restoratives, 

Sialagogues, 

Stimulants, 

Styptics, 

Vesicants. 


Absorbents,  known  also  as  Desiccatives,  are  medicinal  agents 
capable  of  checking  secretions,  and  drying  up  secretions  or 
discharges  from  ulcers  and  suppurating  wounds.  Included  in 
this  class  are  tannic  acid,  oxide  of  zinc,  charcoal,  subnitrate  of 
bismuth,  starch,  powdered  galls,  magnesia,  powdered  myrrh, 
carbonate  of  lime,  etc.,  etc. 

ANODYNES. 

Anodynes,  which,  with  sedatives,  hypnotics  or  soporifics,  are 
included  in  the  group  of  narcotics,  are  medicinal  agents  capa- 
ble of  alleviating  pain.  Included  in  this  class  are  opium, 
morphia,  chloroform,  sulphuric  ether,  aconite,  croton-chloral, 
belladonna,  camphor,  gelsemium,  cannabis  indica,  stramonium, 
hyoscyamus,  carbolic  acid,  atropine,  creasote,  etc.,  etc. 

ANTEMETICS. 

Antemetics  are  medicinal  agents  capable  of  arresting  vom- 
iting. Included  in  this  class  are  creasote,  dilute  hydrocyanic 
acid,  lime  water,  chloral,  chloroform,  magnesia,  dilute  nitric 
acid,  dilute  phosphoric  acid,  belladonna,  oxalate  of  cerium,  etc. 

ANTHRIDROTICS. 

Anthridrotics  are  medicinal  agents  capable  of  checking 
perspiration.  Included  in  this  class  are  oxide  of  zinc,  sulphuric 
acid,  acetic  acid,  tannic  acid,  sulphate  of  iron,  haemotoxylin,  etc. 


82  DENTAL    MEDICINE. 


ANTIPERIODICS. 

Antiperiodics  are  medicinal  agents  capable  of  relieving 
periodical  diseases,  such  as  intermittent  fevers,  neuralgia,  etc. 
Included  in  this  class  are  cinchona,  quinia,  arsenic  (in  form  of 
Fowler's  solution),  chloroform,  chloride  of  soda,  salicin,  etc. 

ANTISEPTICS. 

Antiseptics  are  medicinal  agents  capable  of  arresting  fermen- 
tative processes,  thereby  preventing  the  decomposition  of 
organic  substances.  When  these  agents  are  brought  in  contact 
with  disease  germs,  they  destroy  their  vitality.  Included  in 
this  class  are  carbolic  acid,  creasote,  salicylic  acid,  eucalyptus 
oil,  iodoform,  benzoic  acid,  boracic  acid,  pepsin,  bromine,  etc. 

CARMINATIVES. 

Carminatives  are  medicinal  agents  capable  of  dispelling  flatu- 
lence, and  allaying  pain  in  the  stomach  and  bowels.  Included 
in  this  class  are  such  agents  as  cinnamon,  cardamom,  cloves, 
coriander,  lavender,  ginger,  juniper,  carraway,  peppermint,  etc. 

CAUSTICS. 

Caustics  are  medicinal  substances  capable  of  destroying 
vitalized  tissue.     (See  Irritants}) 

CAUTERANTS     (See  Irritants). 

CONSTRINGENTS    {^^^  Astringents). 

COUNTER-IRRITANTS, 

Counter-irritants  are  medicinal  agents  which  are  employed 
to  produce  external  irritation  for  the  purpose  of  relieving  or 
curing  diseased  action  in  another  part,  as  in  periodontitis,  for 
example,  when  such  agents  as  iodine,  cantharidal  collodion, 
creasote  and  iodine,  ammonia,  etc.,  etc.,  are  applied  to  the  gum 
over  the  root  of  the  affected  tooth.     (See  Irritants}) 

DESICCATIVES. 

Desiccatives  are  medicinal  agents  capable  of  checking  secre- 
tions, and  arresting  mucous  discharges  from  ulcers,  wounds^ 
etc.     (See  Absorbents}) 


REMEDIAL   AGENTS.  83 


DETERGENTS. 

Detergents  are  medicinal  agents  capable  of  cleansing  ulcers, 

suppurating  wounds,  etc.,  by  acting  as   either  stimulants   or 

emollients.     Included  in  this  class  are  such  agents  as  borax, 

burnt  alum,  slippery  elm  bark,  acacia,  flax  seed,  tragacanth,  etc. 

DEODORIZERS. 

Deodorizers  are  medicinal  agents  capable  of  destroying 
infectious  and  fetid  odors.  Included  in  this  class  are  carbolic 
acid,  salicylic  acid,  creasote,  chloride  of  lime,  charcoal,  perman- 
ganate of  potash,  thymol,  chloride  of  zinc,  solution  of  chloride 
of  soda,  oil  of  eucalyptus,  iodoform,  menthol,  hydrochloric 
acid,  nitric  acid,  sulphuric  acid,  etc.,  etc.     (See  Antiseptics}) 

DILUENTS. 

Diluents  are  medicinal  agents  capable  of  diluting  the  blood> 
and  thus  increasing  its  fluidity  ;  at  the  same  time,  exercising 
a  solvent  action,  and  eliminating  a  portion  of  the  solid  constitu- 
ents. Included  in  this  class  are  such  agents  as  water,  aerated 
water,  mineral  waters,  rice  water,  beef  tea,  whey,  barley  water, 
gruel,  etc.,  etc. 

DISCUTIENTS. 

Discutients  are  medicinal  agents  capable  of  reducing  and 
dispersing  morbid  growths,  swellings,  etc.  Included  in  this 
class  are  iodine,  mercury,  bromide  of  potassium,  iodide  of 
potassium,  chlorate  of  potassium,  arsenic,  colchicum,  etc.,  etc. 

DISINFECTANTS. 
Disinfectants  are  medicinal  agents  capable  of  depriving 
effluvia  of  their  morbific  properties  by  chemically  combining 
with  them.  Included  in  this  class  are  such  agents  as  chlorine, 
carbolic  acid,  carbolate  of  lime,  chloride  of  lime,  salicylic  acid, 
solution  of  chlorinated  soda,  charcoal,  creasote,  hydrochloric 
acid,  sulphuric  acid,  nitric  acid  and  chloride  of  zinc.  (See 
Antiseptics  and  Deodorizers}) 

EMOLLIENTS. 
Emollients,  or  Protectives,  are  medicinal  agents  capable  of 
relaxing  soft  tissues,  allaying  irritation,  protecting  sensitive 


84  DENTAL    MEDICINE. 


surfaces,  relieving  pain  in  ulceration  of  mucous  membrane. 
Included  in  this  class  are  glycerine,  collodion,  solution  of 
gutta  percha,  acacia,  tragacanth,  Irish  moss,  sassafras  pith, 
flaxseed,  slippery  elm  bark,  liquorice  root,  wax,  in  the  form  of 
cerate  ointment,  poultices  of  bread  and  milk,  yeast  and  flax- 
seed, and  charcoal  and  yeast  with  flaxseed,  lard,  etc.,  etc. 

ERRHINES. 

Errhines  are  medicinal  agents  capable  of  inducing  a  secre- 
tion from  the  nose.  Included  in  this  class  are  ammonia,  ipe- 
cacuanha, chlorine,  acetic  acid,  orris  root,  etc.,  etc. 

ESCHAROTICS. 

Escharotics  are  medicinal  agents  capable  of  producing  an 
eschar  or  slough,  and  are  included  among  Irritants.  (See  Irri- 
tants^ 

EXPECTORANTS. 

Expectorants  are  medicinal  agents  capable  of  promoting 
the  excretion  of  mucus  and  other  fluids  from  the  air  passages 
and  lungs.  Included  in  this  class  are  squill,  ipecacuanha, 
benzoic  acid,  preparations  of  ammonia,  tartar  emetic,  balsam 
of  tolu,  myrrh,  nitrate  of  potash,  seneca,  wild-cherry  bark, 
lobelia,  etc.,  etc.     {See  Blennorrhetics) 

EVACUANTS. 

Evacuants  belong  to  the  class  of  cathartics  which  promote 
alvine  evacuations.     (See  Cathartics.) 

EXCITANTS. 

Excitants  belong  to  the  class  of  stimulants  which  excite  the 
vital  powers,  causing  an  increase  of  the  circulation.  (See 
Stimulants^ 

FEBRIFUGES. 

Febrifuges  are  medicinal  agents  capable  of  diminishing  the 
heat  and  allaying  the  thirst  of  fevers,  and  are  generally  recog- 
nized as  Refrigerants.  Included  in  this  class  are  nitrate  of 
potassa,  chlorate  of  potassa,  the  mineral  acids,  spirits  of  nitrous 
ether,  etc.,  etc. 


REMEDIAL  AGENTS.  85 


HEMOSTATICS. 

Haemostatics  are  medicinal  agents  capable  of  arresting 
hemorrhage,  and  belong  to  the  class  of  Astringents.  (See 
Astringents  and  Styptics}) 

HYPERSTHENICS. 
Hyper.sthenics   belong   to  the    class   of    Stimulants.     (See 

Stimulants^ 

HYPNOTICS. 

Hypnotics  belong  to  the  class  of  Narcotics,  and  are  capable 
of  causing  sleep.     (See  Naixotics.) 

■LAXATIVES. 

Laxatives  are  mild  cathartics.     (See  Cathartics?) 

NERVINES. 

Nervines  belong  to  the  class  of  Neurotics,  and  are  capable 
of  relieving  and  curing  disorders  of  the  nerves.  (See  Neu- 
rotics.) 

NUTRITIVES. 

Nutritives  are  medicinal  agents  capable  of  quickening  assimi- 
lation and  building  up  the  organic  tissues.  Included  in  this 
class  are  cod-liver  oil,  gum  arable,  glycerin,  beef  extracts,  milk, 
manna,  etc.,  etc. 

PURGATIVES. 
Purgatives  are  active  Cathartics.     (See  Cathartics?) 

REFRIGERANTS. 
Refrigerants  are  medicinal  agents  which  are  capable  of 
diminishing  heat  and  allaying  thirst.  They  are  also  called 
Febrifuges.  Included  in  this  class  are  nitrate  of  potassa, 
chlorate  of  potassa,  solution  of  acetate  of  ammonia,  acetic  acid, 
citric  acid,  hydrochloric  acid,  nitric  acid,  tartaric  acid,  spirits 
nitrous  ether,  etc.,  etc. 

RESOLVENTS. 

Resolvents  belong  to  the  classes  of  Alteratives  and  Emol- 
lients, being  medicinal  agents  capable  of  reducing  inflamma- 
tion and  dispersing  morbid  swellings.  (See  Alteratives  and 
Emollients?) 


86  DENTAL    MEDICINE. 


RESTORATIVES. 

Restoratives  belong  to  the  classes  of  Stimulants  and  Tonics. 
(See  Stimulants  and  Tonics) 

SIALAGOGUES. 

Sialagogues  are  medicinal  substances  capable  of  increasing 
the  salivary  secretion  by  a  stimulant  or  irritant  effect.  By  the 
excitant  properties  of  these  agents  the  lining  membrane  of  the 
mouth  is  irritated,  the  effect  extending  along  the  ducts  to  the 
salivary  glands,  so  that  not  only  is  the  quantity  of  fluid  exhaled 
from  the  mucous  membrane  increased,  but  salivation  results. 
In  this  way  depletion  follows  their  employment,  and  more  or 
less  revulsive  effect  ensues,  which  may  prove  beneficial  to 
distant  parts  affected  by  disease.  Sialagogues  may  also  prove 
useful  in  cases  of  paralysis  of  the  tongue,  etc.,  by  their  directly 
excitant  properties ;  in  such  cases  as  local  palsy  of  the  tongue. 
They  are  occasionally  employed  as  masticatories  in  odontalgia, 
and  in  such  affections  of  the  head  as  may  indicate  the  use  of 
substances  which  excite  irritation  in  and  increased  discharge 
from  the  lining  membrane  of  the  nasal  cavities.  Included  in 
this  class  are  pyrethrum,  horse  radish,  calamus,  ginger,  to- 
bacco, calomel,  corrosive  sublimate,  blue  mass,  iodide  of  mer- 
cury, etc. 

STYPTICS. 

Styptics,  which  belong  to  the  class  o^  Astringents,  are  medici- 
nal agents  capable  of  arresting  hemorrhage  when  employed 
externally.  They  are  divided,  according  to  their  action,  into 
chemical  and  mechanical,  the  chemical  styptics  coagulating  the 
blood  exuding  from  the  part,  and  at  the  same  time  stimulating 
the  tissues  to  contraction ;  whilst  the  mechanical,  as  lint,  felt, 
spider's  web,  plaster  of  Paris,  etc.,  detain  the  blood  in  their 
meshes,  or  absorb  it  until  it  coagulates,  and  thus  arrest  the 
hemorrhage.  Among  the  Astringents  which  may  be  classed 
as  Styptics,  are  tannic  acid,  persulphate  of  iron  solution, 
powdered  subsulphate  of  iron,  alum,  nitrate  of  silver,  pow- 
dered galls,  sulphuric  acid,  matico,  gallic  acid,  perchloride  of 
iron. 


THERAPEUTIC    FORMS.  87 

VESICANTS. 

Vesicants,  which  belong  to  the  class  of  Epispastics,  are 
medicinal  agents  capable  of  producing  a  serous  exudation 
beneath  the  cuticle.  Included  in  this  class  are  cantharides, 
cantharidal  collodion,  glacial  acetic  acid,  strong  solution  of 
ammonia,  mustard,  etc.,  etc.     (See  Epispastics?) 

FORMS  IN  WHICH  MEDICINAL  SUBSTANCES  ARE 
EMPLOYED. 

Alkaloids  are  bases  capable  of  combining  with  acids  to 
form  salts,  and  which  exist  as  proximate  principles  in  certain 
vegetables,  and  possess  the  properties  of  an  alkali  in  a  greater 
or  less  degree.  Alkaloids  are  therefore  the  active  principles 
of  medicines. 

Baths.  Medicinal  Baths  are  composed  of  tepid  water,  with 
the  addition  of  saline,  emollient,  narcotic  or  stimulant  sub- 
stances, such  as  salt,  mustard,  etc.,  etc. 

Cataplasms  are  poultices  or  plasters  composed  of  soft, 
macerated  preparations,  to  be  applied  externally. 

CoLLYRiA  are  preparations  applied  to  the  eyes.  They  are 
sometimes  dry,  but  generally  liquid,  consisting  of  infusions, 
decoctions  or  distilled  waters,  with  the  addition  of  various 
medicinal  substances. 

Confections,  or  Electuaries^  are  preparations  made  into  a 
pulpy  mass,  with  sugar  or  honey,  mucilage  or  glycerin. 

Decoctions  are  solutions  made  by  boiling  certain  vegetable 
ingredients  in  a  fluid,  for  the  purpose  of  extracting  the  parts 
soluble  at  that  temperature. 

Emulsions  are  preparations  composed  of  oils,  resins,  etc., 
suspended  by  means  of  mucilage,  yolk  of  ^g^,  sugar,  etc. 

Enemata,  or  Clysters,  are  liquid  preparations  injected  into 
the  rectum  by  means  of  a  syringe,  as  auxiliaries  to  or  substi- 
tutes for  cathartics. 

Extracts  are  preparations  obtained  by  the  evaporation  of 
a  vegetable  solution,  in  the  form  of  juices,  infusions  or  decoc- 
tions, to  a  more  or  less  fluid  consistence. 


DENTAL   MEDICINE, 


Fomentations  are  fluid  preparations  applied  to  the  surface 
of  the  body  by  means  of  a  sponge,  flannel  or  soft  cloth. 

Fumigations  are  the  vapors  of  medicinal  substances  em- 
ployed to  purify  infected  air  by  absorbing  or  otherwise  coun- 
teracting deleterious  gases.  They  are  also  employed  in  dis- 
eases of  the  skin,  and  may  be  sometimes  substituted  for  a  local 
bath. 

Gargles  are  washes  for  the  mouth  and  throat,  and  are 
generally  astrii\gent  and  stimulating,  sedative,  refrigerant,  etc. 
To  be  of  any  service,  gargles  or  mouth  washes  must  be  fre- 
quently applied  and  persevered  in  for  some  time.  They  are 
employed  in  cases  of  inflammation  and  ulceration  of  the 
mucous  membrane  of  the  mouth  and  fauces. 

Glycerites  are  solutions  of  medicinal  substances  in  gly- 
cerine. 

Infusions  are  preparations  obtained  by  pouring  a  hot  or 
cold  fluid  upon  vegetable  substances,  for  the  purpose  of  ex- 
tracting their  medicinal  properties. 

Inhalants  are  remedies  in  the  form  of  steam,  for  inhalation 
directly  to  the  lungs. 

Injections  are  medicated  fluids  thrown  into  a  natural  or 
preternatural  cavity  of  the  body  by  means  of  a  syrmge. 

Liniments,  or  Embrocations,  are  unctuous  medicinal  prepa- 
rations to  be  applied  externally  by  means  of  friction. 

Lotions  are  liquid  preparations,  or  washes,  to  be  applied  to 
the  body  externally. 

Mixtures  are  fluid  preparations  containing  several  medici- 
nal ingredients,  to  be  administered  by  the  mouth. 

Ointments,  or  Cerates,  are  preparations  of  the  consistence 
of  lard,  composed  of  wax,  lard,  or  resin,  with  solid  or  liquid 
ingredients,  for  topical  application.  Cerates  are  somewhat 
harder  than  ointments,  especially  where  wax  is  substituted  for 
the  lard. 

Pills  are  simple  or  compound  medicinal  agents,  of  a  firm 
consistence,  spherical  or  globular  in  shape,  and  generally  not 
exceeding  five  or  six  grains  in  weight. 

Plasters   are   preparations  of  a  solid  glutinous    composi- 


THERAPEUTIC    FORMS.  89 

tion,  which,  at  the  ordinary  temperature  of  the  body,  adheres 
to  the  part  on  which  it  is  placed. 

Suppositories  are  soHd  preparations,  of  a  round,  cyHndrical, 
or  conical  form,  to  be  introduced  into  the  anus  ;  and  are  com- 
posed of  sedative,  astringent,  or  purgative  medicines,  combined 
with  suet,  cocoa-butter,  honey,  or  soap. 

Syrups  are  liquid  conserves,  made  by  dissolving  sugar  with 
some  plant,  or  in  water,  either  with  or  without  medicinal 
impregnation. 

Tinctures  are  preparations  in  the  form  of  solutions  of  the 
active  portions  of  medicinal  substances,  in  rectified  or  proof 
spirits.  A  tincture  is  called  simple  when  it  holds  only  one 
substance  in  solution,  and  compound,  when  two  or  more  ingre- 
dients are  submitted  to  the  solvent. 


DENTAL   MATERIA   MEDICA  AND 
THERAPEUTICS. 


ACACIA— GUM  ARABIC. 

Source.  A  thorny  tree  or  shrub,  of  Arabia  and  Africa. 
Description.  The  concrete  juice  which  exudes  spontaneously 
from  the  stem  of  the  Acacia  vera,  in  the  form  of  a  gum, 
which  hardens,  on  exposure,  in  small,  irregular,  or  roundish 
or  oval  pieces,  of  various  sizes,  more  or  less  transparent,  hard, 
brittle  and  pulverizable.  It  is  generally  either  white  or  yellow- 
ish white,  but  sometimes  of  a  deep  orange  or  brownish  color; 
the  powder,  however,  being  pure  white.  It  is  inodorous,  with 
a  feeble,  slightly  sweetish  taste,  and  when  pure  dissolves 
wholly  away  in  the  mouth. 

In  water  it  forms  a  viscid  solution,  known  as  mucilage. 
It  is  insoluble  in  alcohol,  ether  and  the  oils.     When  kept 
dr}',  it  undergoes  no  change. 

Chemical  Constituents.  It  consists  of  a  peculiar  proximate 
principle  known  as  Gtim  or  Arabin,  composed  chiefly  of  a  solu- 
ble acid  substance,  Ginmnic  Acid  (HaCisHigOioHaO),  combined 
with  3  per  cent,  of  lime,  forming  a  soluble  salt,  gummate  of 
calcium. 

Medicinal  Properties  and  Action.  Demulcent  and  emollient. 
It  forms  an  excellent  adjunct  to  other  medicinal  substances  of 
the  same  class,  and  an  ingredient  in  all  the  officinal  lozenges. 

Dose.  Of  the  Gum,  oj  ad  libitum.  Of  the  Mucilage  (oiv., 
water  Svj)  Sij  to  Svj  daily,  or  ad  libitum. 

Therapeutic  Uses.  Coughs  and  hoarseness,  gastro-intestinal 
irritation,  infantile  diarrhoea,  epistaxis  and  superficial  hemor- 
rhages ;  applied  in  the  form  of  fine  powder. 

Dental  Uses.  As  an  emollient,  in  the  form  of  mucilage,  to 
cover  and  protect  inflamed  surfaces  of  mucous  membrane. 

90 


ACIDUM    ACETICUM ACETIC    ACID.  91 

As  a  mechanical  styptic,  in  a  finely-powdered  form,  in  super- 
ficial hemorrhages,  such  as  fi-om  leech-bites,  etc. 

Combined  with  borax,  it  is  a  usefial  application  for  inflamed 
mucous  membrane. 

DENTAL  FORMULA. 

Fo7-  hiflamed  Mucous  Surfaces. 
R.     Pulveris  Acacias ^ij 

Sodii  Boratis ^ij. 

Fiat  pulvis. 
SiGNA. — Apply  to  inflamed  part. 

ACIDUM  ACETICUM— ACETIC  ACID. 

Formula.     HC2H3O2. 

Derivation.  Purified  Pyroligneous  Acid.  Prepared  from 
wood  by  destructive  distillation  ;  contains  28  per  cent,  of  anhy- 
drous acetic  acid.     Specific  gravity  1.047. 

Dilute  Acetic  Acid — Acidiim  Aceticum  Dihitmn,  the  only 
form  in  which  it  is  employed  internally,  is  prepared  by  mixing 
one  pint  of  acetic  acid  with  seven  pints  of  distilled  water. 
Specific  gravity  i  .006. 

Medical  Properties  and  Action.  Refrigerant,  diaphoretic, 
astringent,  diuretic,  stimulant,  tonic.  It  allays  restlessness 
by  allaying  thirst,  and  acts  upon  the  skin  and  kidneys  ;  also 
acts  as  an  antiscorbutic.  The  strong  acid  applied  to  the  skin 
causes  intense  redness  and  pain,  followed  by  rapid  vesication. 

Dose.  Of  Acetic  Acid,  gtt.  iij  to  x.  Of  Dilute  Acetic  Acid, 
5j  to  ij. 

TJierapeiLtic  Uses.  Fevers,  night  sweats,  diarrhoea,  scurvy, 
hemorrhage  of  the  lungs,  stomach  and  nose.  Externally, 
the  strong  Acetic  Acid  is  applied  in  tinea  capitis,  psoriasis, 
cancer,  corns,  and  warts ;  the  dilute  form  is  applied  externally 
to  gangrene,  ulcerated  throat,  in  the  form  of  gargle,  ulcers, 
sprains,  and  bruises.  Owing  to  its  volatility  and  pungency,  its 
vapor,  when  applied  to  the  nostrils,  acts  as  an  excitant  in 
syncope,  headache,  etc. 

Dental  Uses.  Acetic  Acid  is  externally  employed  in  indo- 
lent ulcers  of  the  mouth,  cancrum  oris,  and  scurvy.    In  the  form 


92  DENTAL    MEDICINE. 


of  Glacial  Acetic  Acid — Acidmn  Acetiann  Glaciale  (Concen- 
trated Acetic  Acid),  it  is  applied  externally,  as  a  caustic  in 
fungous  growths  of  gum,  dental  pulp,  etc.  In  cancerous 
ulcerations  of  mucous  membrane,  it  relieves  the  pain,  and 
promotes  a  healthier  condition. 

DENTAL  FORMULAE. 

For    Indolent     Ulcers    of   the  Month,  Po^  Inflcmied  Fauces. 

Cancrum   Oris,  Scurvy.       •  R  .    Acidi  Acetici f^ij 

R.    Acidi  Acetici f5iij  Ammonii  Chloridi -••3J 

Aquse f,^  v.  Mellis f^  jss 

Fiat,  solution.  Aquae f^^ij- 

SiG. — Apply  with  a  camel's-hair  brush.  Fiat.  Gargarysma. 

ACIDUM  ARSENIOSUM— ARSENIOUS  ACID. 
White  Oxide  of  Arsenic — Arseniosum  Oxidum. 

Formula.     AsgOg. 

Arsenic-arsenicum,  the  metal  from  which  arsenious  acid  is 
obtained,  is  not  employed  as  a  medicine  in  its  native  state.  It 
is  combined  with  sulphur  and  certain  metals,  and  is  hard, 
brittle,  crystalline,  of  a  steel-gray  color.  When  heated  to  a 
dull  redness,  it  volatilizes  in  the  form  of  a  colorless  vapor, 
with  an  odor  like  that  of  garlic — alliaceous.  It  is  generally 
found  in  cobalt  ore.     It  is  a  powerful  poison. 

Derivation.  Arsenious  Acid  is  obtained  by  roasting  arsenical 
ores,  and  purifying  by  sublimation.  It  is  in  the  form  of  a  fine 
white  powder,  which  is  often  adulterated  with  chalk,  lime,  etc. ; 
hence  it  is  better  to  procure  it  in  the  solid  form  or  lump,  which 
is  of  a  milk-white  color  externally,  and  often  perfectly  trans- 
parent internally.  It  has  no  odor,  and  is  therefore  liable  to 
be  mistaken  for  more  innocent  substances,  and  scarcely  any 
taste,  or  merely  a  faint,  sweetish  impression. 

Medical  Properties  and  Action.  Arsenious  Acid  in  large 
doses  is  a  virulent  irritant  poison,  but  in  doses  of  one-sixtieth 
to  one-twelfth  of  a  grain,  properly  administered,  it  is  a  tonic, 
increasing  the  appetite  and  improving  the  secretions,  both  in 
quality  and  quantity.  In  larger  doses,  in  the  form  of  Fowler's 
Solution — Liqiior  Potassii  Arsenitis  (prepared  by  boiling  64 
grains  of  arsenious  acid  and  bicarbonate  of  potassium,  each  in 


ACIDUM    ARSENIOSUM ARSENIOUS    ACID.  93 

half  a  fluid  ounce  of  distilled  water,  then  adding  12  fluid  ounces 
more  of  distilled  water,  half  a  fluid  ounce  of  compound  spirit 
of  lavender,  and  afterwards  water  enough  to  make  the  solu- 
tion measure  a  pint) — it  is  a  powerful  antiperiodic.  In  small 
doses,  administered  for  a  considerable  time,  it  modifies  the 
blood,  and  through  it  nutrition,  so  as  to  remove  various  mor- 
bid conditions.  When  continuously  used,  a  sensation  of  heat 
in  the  throat,  oesophagus  and  stomach  is  sometimes  experi- 
enced, with  nausea,  pain  in  the  stomach  and  occasional  vomit- 
ing ;  also,  great  languor  or  depression  of  spirits,  with  redness 
of  the  eyes,  swelling  of  the  eyelids  and  oedema  of  the  face  ; 
hence,  at  the  first  evidence  of  such  symptoms,  the  remedy 
should  be  discontinued  until  they  have  passed  away.  When 
continually  increasing  doses  are  administered,  the  arsenic 
accumulates,  and  poisonous  symptoms  quickly  appear ;  hence, 
it  is  recommended  to  begin  a  course  of  arsenic  with  large 
doses,  and  the  quantity  given  regularly  reduced.  When  arsen- 
ious  acid  is  administered,  the  bowels  should  be  well  evacuated 
by  a  purgative  given  previously,  and  the  arsenic  taken  directly 
after  a  meal,  but  never  upon  an  empty  stomach,  on  account  of 
gastric  irritation.  Its  use  should  be  omitted  for  a  day  or  two 
every  two  or  three  weeks,  and  a  mild  aperient  employed,  in 
order  to  prevent  the  accumulation  of  the  arsenic  in  the  system. 
A  few  drops  of  laudanum  added  to  the  arsenical  preparation 
will  prevent  nausea  and  vomiting.  All  arsenical  preparations 
should  be  administered  with  the  greatest  regularity,  at  stated 
times. 

During  the  employment  of  arsenic  the  eyes  of  the  patient 
should  be  examined  daily,  and  if  the  eyelids  and  conjunctiva 
become  inflamed  the  remedy  should  be  discontinued ;  also, 
when  the  urine,  from  being  pale  and  copious,  becomes  scanty, 
acid  and  high-colored,  the  arsenic  should  be  suspended. 

Poisonous  symptoms  have  been  caused  by  half  a  grain  of 
arsenious  acid,  and  fatal  effects  have  followed  the  administra- 
tion of  two  grains,  although  much  larger  quantities  have  been 
taken  with  impunity ;  very  large  quantities  often  causing 
emesis,  which  removes  the  substance  from  the  stomach,  and 


94  DENTAL   MEDICINE. 


thus  prevents  fatal  effects.  When  the  idiosyncrasies  of  the 
patient  are  unknown,  it  is  better  to  use  small  doses  before 
beginning  with  large  doses.  The  quantity  of  arsenic  required 
to  produce  a  fatal  effect  varies  according  to  the  susceptibilities 
of  the  patient  and  the  state  of  the  stomach.  Much,  however, 
depends  on  the  idiosyncrasies  of  the  individual,  which  differ 
greatly  in  different  persons.  When  large  quantities  are  taken, 
the  effects  are  sometimes  manifested  on  the  cerebro-spinal 
system,  death  following,  from  narcotism,  in  a  short  time. 

When  arsenious  acid  is  swallowed  or  applied  to  a  denuded 
surface,  it  is  rapidly  absorbed  into  the  system  ;  hence  it  is  a 
dangerous  agent,  and  in  every  case  should  be  carefully  used, 
and  its  effects  closely  watched.  It  possesses  a  very  powerful 
antiseptic  property,  arresting  the  process  of  putrefaction.  The 
stomach  and  alimentary  canal  of  persons  who  have  died  from 
its  effects  have  been  found  in  a  perfect  state  of  preservation  for 
a  long  time  after  interment. 

Poisonous  doses  produce  great  intestinal  inflammation,  with 
ulceration  in  some  cases,  and  rarely,  gangrene.  It  has  also 
been  detected  after  death,  in  the  blood,  in  the  urine,  and  also 
in  the  liver,  spleen,  kidneys,  muscles  and  stomach.  A  certain 
degree  of  tolerance  in  the  use  of  arsenic  may  be  established, 
where  poisonous  doses  can  be  taken  with  impunity.  Such  a 
state  may  be  produced  by  the  constant  legitimate  use  of  the 
agent,  or  in  the  cases  of  thosfe  who  begin  the  habit  of  arsenic 
eating  at  an  early  age,  and  who  find  this-  practice  of  service  in 
increased  breathing  power,  strength,  and  improved  bodily  con- 
dition. As  long  as  such  a  habit  is  continued,  no  ill  effects  are 
apparent,  but  as  soon  as  the  arsenic  is  discontinued,  symptoms 
resembling  those  of  poisonous  doses  make  their  appearance. 

Arsenious  acid  acts  locally  as  an  escharotic,  but  while  a 
true  escharotic  acts  chemically,  producing  decomposition  of 
the  part  to  which  it  is  applied,  a  state  incompatible  with  life, 
arsenic  destroys  the  vitality  of  the  organized  structure,  and  its 
decomposition  is  the  consequence.  This  distinction  should  be 
remembered  in  the  use  of  arsenious  acid  in  dental  practice. 

Arsenic  is  eliminated  by  the  liver,  kidneys,  intestinal  canal 


ACIDUM    ARSENIOSUM ARSENIOTJS    ACID.  95 

and  bronchial  tubes ;  and  it  is  thought  that  some  of  the  symp- 
toms produced  by  it  have  their  origin  in  the  local  effects  of 
the  poison  on  the  channels  of  excretion. 

The  symptoms  of  gastro-intestinal  arsenical  poisoning — the 
more  common  form — are  described  by  Bartholow  as  follows  : 
Burning  sensation  at  the  epigastrium,  and  extending  over  the. 
abdomen  ;  violent  and  uncontrollable  vomiting ;  excessive  dry- 
ness of  the  mouth  and  fauces,  intense  thirst,  intestinal   irrita- 
tion, bloody  and  offensive  stools,  retracted  abdomen,  strangury, 
suppression  of  urine,  or  bloody  urine,  and  in   females  menor- 
rhagia ;  rapid  and  feeble  action  of  the  heart,  oppressed  breath- 
ing', p;reat  agitation  and   restlessness,  shrunken  features,  cold 
breath,  involuntary  evacuations,  collapse;  consciousness  being 
retained  to  the  end. 

The  symptoms  of  the  cerebral  form  of  arsenical  poisoning 
are  profound  insensibility  and  coma,  similar  to  extreme  opium 
narcosis.  The  effects  of  arsenical  poisoning,  when  not  fatal, 
are  felt  for  a  long  time  in  the  form  of  gastro-enteric  irritability, 
an  irritable  condition  of  the  skin,  stiffness  of  the  joints,  neural- 
gic pains,  numbness,  formication,  paralysis,  etc. 

After  death  from  arsenical  poisoning,  the  gastro-intestinal 
mucous  membrane  exhibits  deep  redness,  erosions,  ecchymosis 
and  softening.  Death  generally  occurs  in  the  midst  of  con- 
vulsions, followed  by  rigid  spasm  of  the  whole  body. 

When  arsenic  has  been  injudiciously  administered  for  too 
long  a  period,  in  addition  to  the  irritation  of  the  conjunctiva, 
swelling  of  the  face,  desquamation  of  the  skin,  etc.,  salivation 
has  been  observed  in  some  instances,  and  at  times  a  peculiar 
silvery  whiteness  of  the  tongue. 

Dose.  Of  Arsenious  Acid,  gr.  ^V  to  gr.  tV,  in  pills  with  bread 
crumb  three  times  a  day.  Of  Liquor  Potassii  Arsenitis  (Fow- 
ler's Solution),  Ti\,ij  to  n\^x,  three  times  a  day;  each  fluid 
drachm  contains  half  a  grain  of  arsenious  acid. 

Arsenic  is  contraindicated  in  infancy  and  childhood ;  in  all 
sthenic  diseases  accompanied  by  strong  arterial  action ;  in  all 
irritable  conditions  of  the  stomach  and  alimentary  canal ;  and 
in  all  inflammatory  pulmonary  affections. 


96  DENTAL    MEDICINE. 


Therapeutic  Uses.  In  intermittent  and  periodic  diseases, 
such  as  malaria,  neuralgic  and  spasmodic  diseases,  being  of 
great  value  in  neuralgia,  especially  when  of  a  malarial  type, 
hemicrania,  chronic  rheumatism,  asthma,  whooping-cough, 
chorea,  diseases  of  the  skin,  vomiting  of  pregnancy,  hay  fever, 
irritative  dyspepsia,  uterine  affections,  bites  of  venomous 
snakes,  etc.  Externally,  it  is  applied  to  cancerous  growths ; 
hypodermically,  in  cases  of  local  chorea. 

Arsenic  is  also  employed  medicinally  in  the  forms  of  Arseni- 
ate  of  Iron  [Ferri  Arsenias)  and  Arseniate  of  Soda  [SodcE 
Arsenias). 

Dental  Uses.  The  devitalizing  power  of  arsenious  acid  being 
far  more  powerful  than  its  escharotic  power,  it  has  been  em- 
ployed for  many  years  to  destroy  the  vitality  of  the  pulps  of 
teeth,  for  which  purpose  it  is  generally  combined  with  either 
the  acetate  or  sulphate  of  morphia  and  sufficient  creasote  to 
form  a  paste,  to  prevent,  or  at  least  mitigate,  the  extremely 
painful  action  of  the  arsenic  when  topically  applied  to  living 
tissue.  It  was  formerly  supposed  that  creasote  was  a  solvent 
for  the  arsenic,  but  this  is  now  denied.  Carbolic  acid  may  be 
substituted  for  the  creasote. 

As  the  danger  of  absorption  is  great,  there  is  considerable 
risk  in  applying  arsenious  acid  to  the  teeth  of  young  persons, 
or  those  very  susceptible  to  the  influence  of  this  agent ;  hence 
other  escharotics,  such  as  repeated  applications  of  carbolic 
acid,  or  pepsina  porci,  with  dilute  hydrochloric  acid,  or  nitric 
acid,  chromic  acid,  or  chloride  of  zinc,  or  the  galvanic  cautery, 
or  the  surgical  method  of  introducing  into  the  body  of  the 
pulp  a  barbed  wire,  are  employed  in  such  cases.  The  arsenious 
acid,  when  employed  for  the  devitalization  of  dental  pulps,  has 
been  combined  with  pulverized  charcoal,  under  the  impression 
that  the  latter  prevents  the  rapid  absorption  of  the  arsenic, 
and  thus  limits  its  action  mechanically  rather  than  therapeuti- 
cally. 

The  creasote  (or  carbolic  acid),  employed  in  combination 
with  the  arsenious  acid  as  a  nerve  paste,  obtunds  sensibility, 
acting  as  a  styptic,  antiseptic  and  escharotic ;    hence  some 


ACIDUM    ARSENIOSUM ARSENIOUS   ACID.  97 

depend  upon  this  agent  alone  to  modify  the  action  of  the 
arsenic,  and  dispense  with  the  morphia. 

Tannic  acid  and  tincture  of  aconite  are  sometimes  substi- 
tuted for  the  morphia  and  creasote,  or  carbolic  acid,  in  the 
preparation  of  a  nerve  paste.  Arsenious  acid  is  also  employed 
alone,  in  the  form  of  the  dry  powder,  to  devitalize  pulps  of 
teeth  ;  but  it  is  not  only  more  painful,  but  less  prompt  in  its 
action  than  when  it  is  combined  with  other  agents.  Previous 
to  the  application  of  the  arsenical  preparation,  chloroform, 
tincture  of  aconite,  or  sulphate  of  atropia,  may  be  applied  to 
the  exposed  portion  of  the  pulp,  and  the  painful  effect  of  the 
arsenic  be  thus  modified.  The  spray  of  rhigolene,  or  absolute 
ether,  has  also  been  employed  for  this  purpose. 

The  quantity  of  arsenious  acid  to  be  employed  for  devitali- 
zation will  depend  upon  the  structure  and  class  of  the  tooth, 
varying  from  the  A  to  the  A  of  a  grain ;  also  the  length 
of  time  the  arsenical  preparation  should  remain  in  the  tooth, 
as  the  condition  of  the  pulp  and  tooth,  the  age  of  the  patient, 
the  quality  of  the  tooth  structure  and  the  susceptibility  of  the 
patient  should  all  be  considered.  While  in  most  cases  pulps 
are  readily  devitalized  by  the  application  of  a  moderate  quan- 
tity of  the  agent,  in  other  cases,  it  appears  to  be  impossible  to 
accomplish  this  object,  without  extra  measures  are  resorted  to. 
In  teeth  of  a  soft,  frail  structure,  owing  to  an  excess  of  organic 
matter,  the  arsenic  is  rapidly  absorbed ;  but  if,  on  the  other 
hand,  the  tooth  is  of  a  dense  structure,  the  retention  of  the 
arsenical  preparation  for  a  much  longer  time  may  not  be 
attended  with  any  injurious  effects,  such  as  periosteal  inflam- 
mation. From  twelve  to  twenty-four  hours  are  generally  re- 
quired to  enable  the  arsenious  acid  to  properly  devitalize  the 
pulp  of  a  tooth ;  the  difference  in  time  depending  upon  the 
quantity  of  the  acid  employed,  as  well  as  upon  other  circum- 
stances already  enumerated.  To  produce  a  speedy  effect,  the 
pulp  should  be  freely  exposed  by  the  careful  application  of  the 
excavator,  and  the  devitalizing  agent  applied  directly  to  the 
surface  of  the  organ.  Accuracy  as  to  the  quantity  of  the 
arsenious  acid  to  be  employed  may  be  arrived  at  by  having  a 


98  DENTAL    MEDICINE. 


grain  divided  into  twenty  or  twenty-five  parts,  by  weight,  in 
the  form  of  the  dry  powder.  A  pellet  of  cotton,  on  the  end  of 
an  excavator,  may  then  be  saturated  with  creasote  or  carbolic 
acid ;  and  the  desired  quantity  of  the  powder,  being  taken  up 
on  the  pellet,  can  be  placed  directly  in  contact  with  the  ex- 
posed surface  of  the  pulp,  and  secured  in  the  carious  cavity  by 
means  of  a  second  pellet  of  cotton,  saturated  with  either  san- 
darach  or  shellac  varnish,  a  solution  of  gutta  percha  and  chloro- 
form, wax,  or  softened  gutta  percha. 

Some  prefer  to  wound  the  pulp,  so  as  to  draw  blood,  before 
the  application  of  the  arsenical  preparation  is  made,  and  thus 
insure  its  speedy  action.  Care  is  necessary  that  the  arsenic 
should  be  completely  secured  in  the  carious  cavity,  and  no 
portion  of  it  come  in  contact  with  the  parts  outside  of  the 
tooth.  In  the  case  of  proximal  cavities,  a  roll  of  bibulous 
paper,  saturated  with  sandarach  varnish,  may  be  pressed  be- 
tween the  teeth,  beyond  the  cavity,  and  thus  prevent  the 
arsenical  preparation  from  coming  in  contact  with  the  gum 
and  cheek.  After  the  devitalization  of  the  pulp  has  been 
accomplished,  it  is  necessary  that  every  particle  of  the  arsenic 
should  be  removed  from  the  tooth.  The  effect  of  permitting 
the  agent  to  remain  in  the  tooth  for  a  longer  time  than  is 
necessary  for  the  devitalization  of  the  pulp  only,  is  periosteal, 
inflammation.  Where  several  applications  of  the  arsenical 
preparation  fail  to  produce  the  desired  devitalization,  the  resist- 
ance thus  offered  to  the  influence  of  the  agent  may  be  owing 
to  several  causes  :  a  granulated,  protective  covering,  which  is 
formed  over  the  surface  of  the  exposed  portion  of  the  pulp, 
which  defends  it  from  the  action  of  the  arsenic ;  or,  extraordi- 
nary vital  power  in  the  pulp,  which  may  be  due  to  the  peculiar 
constitution  of  the  patient,  who  probably  would  not  be  as  sus- 
ceptible to  the  action  of  arsenic  as  the  majority  of  persons  are, 
even  if  it  were  administered  by  the  mouth. 

Such  resistance  to  the  action  of  the  devitalizing  agent  may 
be  overcome,  either  by  the  removal  of  the  granulated  surface 
where  it  exists,  or,  in  cases  of  non-susceptibility,  by  puncturing 
the  pulp  with  a  pointed  instrument,  charged  with  the  arsenical 


ACIDUM    ARSENIOSUM ARSENIOUS   ACID. 


99 


preparation ;  first  taking  the  precaution  to  obtund  the  sensi- 
bility of  the  organ  by  the  appHcation  of  a  benumbing  agent. 

Arsenious  acid  is  also  employed  in  dental  practice  to  obtund 
the  undue  sensitiveness  of  dentine,  but  less  frequently  now 
than  in  past  years,  as  its  action  is  due  more  to  a  devitalizing 
energy  than  to  a  chemical  action,  such  as  a  true  escharotic 
produces.  As  it  is  capable  of  being  absorbed  through  a  con- 
siderable thickness  of  dentine,  the  result  of  which  would  be 
the  death  of  the  pulp,  arsenious  acid,  if  it  is  employed  for 
obtunding  the  sensibility  of  the  dentine,  should '  be  suffered 
to  remain  in  the  tooth  but  a  very  short  time — from  one  to 
three  hours — and  every  particle  of  it  carefully  removed.  As 
there  are  many  agents  which  prove  effective  for  such  a  pur- 
pose, it  is  much  better  to  refrain  from  the  use  of  arsenious  acid 
as  an  obtunder  of  dentinal  sensibility. 

DENTAL  FORMULA. 


For  Devitalizing  Pulps  of  Teeth. 


Flagg. 

R  .    Acidi  Arseniosi gr.  j 

Morphinse  Acetatis gr.  ij 

Acidi  Carbolici gtt.  iij.    M. 

Fiat  massa. 
SiGNA. — The     proper    quantity  to     re- 
main 12  to  24  hours. 

R.    Acidi  Arseniosi gr.  xx 

Morphinse  Acetatis gr.  x 

Creasoti q.  s. 

To  make  a  thick  paste. 
SiGNA. — To  remain  12  to  24  hours  for 
adults ;  8  to  10  hours  for  children. 


Pierce. 

R.    Acidi  Arseniosi gr.  x 

Morphinse  Sulphatis....gr.  xx 

Creasoti q.  s. 

To  make  a  thick  paste. 
SiGNA. — To  remain  24  hours  for  adults ; 
10  hours  for  children. 


J.  D.  White. 

R.    Acidi  Arseniosi gr.  ij 

Morphinse  Sulphatis gr.  j 

Creasoti q.  s. 

Fiat  massa. 
SiGNA. — To    remain    from     12  to 
hours. 


Garrettson. 
R .    Acidi  Arseniosi 

Morphinae  Acetatis.. aa..gr.  x 

Creasoti q.  s. 

To  make  a  thick  paste. 
SiGNA. — To  remain  24  hours  for  adults ; 
10  hours  for  children. 
If  a  very  irritable  condition  is  pres- 
ent, Sulphate  of  Atropia  may  be  sub- 
stituted for  the  Morphia. 

Hollander. 

R.    Acidi  Arseniosi gr.  xlj 

Morphinse  Acetatis gr.  ij 

M.  Olei  Caryophylli gtt.  iv 

Creasoti q.  s. 

24         Ut  fiat  pasta. 


100  DENTAL    MEDICINE. 


R.    Acidi  Arseniosi gr.  v  R  .    Acidi  Arseniosi gr- x 

Acidi  Tannic! gr.  x  Morphinae  Acetatis gr.  xl 

Tincturse  Aconiti q.  s.  Creasoti,  vel  Acidi  Carbolici..q.  s. 

To  make  a  thick  paste.  To  make  a  thick  paste. 

SiGNA.— To  remain  24  hours.  Sigma. — To  remain  12  to  24  hours. 

To  Destroy  Cancerous  Tumors.  p^^  Malignant   Ulcerations  of  a  Can- 

R.    Acidi  Arseniosi ^j.  cerous  Character. 

Adipis  R.    Liquoris  Hydrargyri  Nitratis..f^^  j. 

Cerati  Cetacei...; .aa 3'vj-  A  powerful  caustic. 

SiGNA. — Melt  the  cerate  and  lard  over  SiGNA. — Applied  by  means  of  a  camel- 

a  slow  fire,  and  then  stir  in  the  ar-  hair  brush,  and  the  parts  then  cov- 

senic,   and   triturate    carefully    in  a         ered  with  lint, 
glass  mortar. 


Tests  for  Arsenic.  Arsenic,  in  the  solid  state,  may  be  de- 
tected by  its  volatility;  heated  over- a  spirit-lamp,  it  passes  off 
in  the  form  of  a  white  vapor,  devoid  of  smell,  and  is  deposited 
on  a  cool  surface,  as  an  amorphous  powder,  or  in  octahedral 
crj'stals.  When  arsenic  is  thrown  on  burning  charcoal,  it  is 
deoxidized,  and  gives  out  the  garlic  odor  of  metallic  arsenic. 
When  heated  in  a  glass  tube  with  charcoal  or  black  flux,  it 
sublimes,  and  condenses  in  the  form  of  a  brilliant  steel-gray 
ring  or  mirror. 

The  following  reagents  will  detect  it  when  it  is  in  aqueous 
solution  :  Sulphuretted  hydrogen,  or  sulphide  of  ammonium, 
produces  a  lemon  or  yellow  sulphide  of  arsenic ;  the  addition 
first  of  ammonia,  and  then  of  nitrate  of  silver,  produces  a  light- 
yellow  arsenite  of  silver ;  the  addition  of  potassa,  and  then  of 
sulphate  of  copper,  produces  a  light-green  arsenite  of  copper. 
The  most  delicate  test,  however,  is  that  of  nascent  hydrogen, 
known  as  Marsh's  Test,  which  consists  of  subjecting  the  arsenic 
to  the  action  of  nascent  hydrogen  (evolved  by  the  action  of 
diluted  sulphuric  acid  on  pure  zinc) ;  it  is  deoxidized,  and 
unites  with  the  hydrogen  to  form  arseniuretted  hydrogen  gas, 
which  has  the  odor  of  garlic,  and  burns  with  a  bluish-white 
flame,  depositing  a  black  spot  of  metallic  arsenic  on  the  sur- 
face of  a  cold  plate  held  directly  in  the  jet. 

Reinsch's  Test  consists  in  boiling  the  suspected  material 
with  hydrochloric  acid  and  clean  copper  foil,  when,  if  any 


ACIDUM  BENZOICUM BENZOIC  ACID.  101 


arsenic  is  present,  the  copper  foil  becomes  coated  with  gray 
metalHc  arsenic. 

Cobalt — Cobaltuvi  [Formula,  Co) — is  a  metal  chiefly  found 
in  combination  with  arsenic,  either  in  the  form  of  the  arsenide 
[tin-white  cobalt),  or  as  gray  cobalt  ore,  with  sulphur  and 
arsenic.  The  late  Dr.  Robert  Arthur  preferred  cobalt  as  a 
devitalizing  agent  to  arsenious  acid,  being  of  the  opinion  that 
less  irritation  followed  its  action,  and  consequently  greater 
immunity  from  periosteal  inflammation.  Others,  however,  do 
not  regard  cobalt  as  being  any  safer,  but,  on  the  other  hand, 
less  prompt  in  its  action  as  a  devitalizing  agent. 

ACIDUM  BENZOICUM— BENZOIC  ACID. 

Formula,  HC7H5O2. 

Derivation.  Benzoic  Acid  is  obtained  from  benzoin  (a  bal- 
samic resin,  which  exudes  from  the  incised  stem  of  a  tree  of 
Sumatra,  Java,  Borneo  and  Siam),  either  by  sublimation  or  by 
the  action  of  alkalies ;  it  is  also  made  from  hippuric  acid.  It 
is  in  the  form  of  white  feathery  crystals,  of  a  silky  lustre,  a 
peculiar,  agreeable  odor  and  warm,  acidulous  taste.  While  it 
is  sparingly  soluble  in  cold  water,  it  is  more  soluble  in  warm 
or  boiling  water,  and  very  soluble  in  alcohol,  solutions  of 
potassa,  soda,  ammonia,  lime,  and  concentrated  sulphuric  and 
nitric  acids.  The  fixed  oils  also  dissolve  it.  From  solution 
it  crystallizes  in  transparent  prisms.     It  is  also  inflammable. 

Medical  Properties  and  Action.  Benzoic  acid  is  stimulant, 
particularly  of  mucous  surfaces,  and  its  vapor  causes  great 
irritation  of  the  air  passages.  It  is  also  antiseptic  and  expec- 
torant, and  some  claim  that  it  is  a  more  powerful  antiseptic 
than  carbolic  acid.  Like  salicylic  and  boracic  acids,  it  pre- 
vents fermentations  and  putrefaction  and  destroys  minute 
organisms.  In  the  system,  it  is  converted  into  hippuric  acid, 
by  the  assumption  of  the  elements  of  glycocoll,  and  in  this 
form  is  excreted  in  the  urine ;  a  large  part  is  excreted  by  the 
kidneys,  as  benzoic  acid. 

Therapeutic  Uses.     Benzoic  acid  is  employed  in  chronic  cys- 


102  DENTAL    MEDICINE. 


titis,  gout,  calculous  diseases,  jaundice,  incontinence  of  urine 
in  children,  etc. 

Dose:  gr.  x. 

Dental  Uses.  Benzoic  acid  may  be  employed  as  an  antisep- 
tic in  suppurating  and  gangrenous  conditions  of  the  pulps  of 
teeth  and  mucous  membrane ;  also  as  a  local  haemostatic  in 
combination  with  powdered  alum.  It  forms  one  of  the  ingre- 
dients of  Dr.  Chapin  A.  Harris'  Gum  Wash. 

The  tinctures  of  benzoin  are  employed  in  the  treatment  of 
unhealthy  or  sloughing  wounds,  flabby  granulations,  foul 
ulcers,  as  they  destroy  the  fetor  and  stimulate  to  a  more 
healthy  growth.  In  the  antiseptic  employment  of  benzoic 
acid,  it  may  be  used  as  a  substitute  for  boracic  and  salicylic 
acids.  The  addition  of  borax  will  increase  its  solubility  in 
water. 

Benzoate  of  Ammonium — Aminonii  Bensoas — will  dissolve 
phosphatic  calculi,  if  its  use  is  long  continued. 

Benzoated  Lard,  when  employed  in  the  preparation  of  oint- 
ments, prevents  chemical  change,  such  as  rancidity  or  acridity. 
It  is  prepared  by  digesting,  at  a  moderate  heat,  5ij  of  powdered 
benzoin  with  a  pound  of  lard. 

Listerine,  the  formula  of  which  is  thyme,  eucalyptus,  baptisia, 
gaultheria,  and  mentha  arvensis,  in  combination,  each  fluid 
drachm  also  containing  two  grains  of  benzo-boracic  acid,  is 
largely  employed  as  an  antiseptic,  deodorizer,  and  disinfectant, 
in  surgical  practice,  in  the  form  of  a  lotion,  a  gargle,  a  dressing, 
or  an  injection.  In  dental  practice,  listerine  is  reliable  in 
carious  teeth,  ulcerations  of  mucous  membrane,  and  wounds 
of  the  mouth,  in  the  form  of  a  lotion  or  dressing ;  for  alveolar 
abscesses,  in  the  form  of  an  injection;  after  the  extraction  of 
teeth,  as  a  mouth-wash ;  and  for  offensive  breath,  as  a  gargle. 
It  may  be  employed  in  its  full  strength,  or  in  various  degrees 
of  dilution  with  water. 

For  such  diseases  as  diphtheria,  catarrh,  dysentery,  scarlatina, 
erysipelas,  smallpox,  different  forms  of  fevers,  etc.,  the  dose  is 
one  teaspoonful  three  or  more  times  a  day  (as  indicated). 


ACIDUM  CARBOLICUM CARBOLIC  ACID.         103 

ACIDUM   CARBOLICUM— CARBOLIC  ACID. 
PhenicAcid;  Phenyl  Alcohol;  Phenylic  Acid. 

Formtila,  CgHgOH. 

Derivation.  Carbolic  acid  is  obtained  from  coal  tar  by  frac- 
tional distillation  and  subsequent  purification,  being  extracted 
from  that  part  of  the  heavy  coal-tar  oils  which  distill  over 
between  150°  and  200°  Centigrade.    Specific  gravity  1.065. 

When  pure,  it  is  in  the  form  of  colorless  acicular  crystals, 
which  at  95°  F.  become  an  oily  liquid,  possessing  a  strong 
odor  and  taste,  closely  resembling  creasote,  which  it  resembles 
in  characters  and  properties,  although  it  is  a  different  substance. 
Much  of  what  is  called  creasote  is  nothing  but  impure  carbolic 
acid  {Acidum  Carbolicum  Impuriim),  combined  with  two  other 
substances,  similar  in  constitution,  and  known  as  crcasole  and 
phosole. 

Chemically  considered,  carbolic  acid  is  an  alcohol  rather 
than  an  acid,  and  its  crystals  readily  absorb  moisture  on 
exposure  to  the  air,  and  are  thus  liquefied. 

It  crystallizes  at  70°  F.,  and  becomes  liquid  at  from  90°  to 
95°  F.,  and  fuses  at  93°  to  106°.  It  is  freely  soluble  in  alcohol, 
ether,  chloroform,  glycerine  and  the  essential  oils.  When 
carbolic  acid  is  liquefied  and  discolored  by  exposure,  it  is  diffi- 
cult to  detect  it  from  creasote,  as  it  possesses  the  same  odor, 
taste,  caustic  properties,  and  a  like  affinity  for  albumen.  Car- 
bolic acid  is  soluble  in  from  twenty  to  twenty-three  parts  of 
water,  the  purest  being  the  most  soluble.  A  small  quantity 
of  water  will  convert  it  into  the  liquid  state,  but  will  not  dis- 
solve it.  Crystallized  carbolic  acid  may  be  dissolved  by  a 
small  quantity  of  cologne  water;  and  to  prevent  recrystalliza- 
tion  and  prepare  it  for  use  in  the  form  of  injections,  for  exam- 
ple, the  bottle  containing  it  should  be  warmed  by  immersion 
in  hot  water,  until  it  becomes  fluid,  and  about  five  per  cent,  of 
rectified  alcohol,  or  a  few  drops  of  glycerine,  be  added. 

The  red  color  which  it  assumes  on  exposure  is  thought  to 
be  caused  by  the  ammonia  in  the  air,  and  also  to  the  presence 
of  copper  in  the  acid,  which  is  affected  by  the  ammonia  of  the 
atmosphere. 


104  DENTAL    MEDICINE. 


Medical  Properties  and  Action.  Carbolic  acid  resembles 
creasote  so  closely,  in  many  of  its  characters  and  medicinal 
properties,  that  the  therapeutic  applications  are  the  same  in 
the  case  of  both  of  these  substances.  Many,  however,  con- 
sider carbolic  acid  to  be  more  efficacious  in  obstinate  dis- 
charges than  creasote ;  and  also  less  irritating  in  its  crystalline 
form  when  applied  to  very  sensitive  organs,  such  as  the  pulp 
of  a  tooth. 

In  its  pure  state  it  is  escharotic ;  when  diluted,  it  is  rube- 
facient, anaesthetic  and  antiseptic.  Internally  administered,  it 
is  sedative  and  carminative,  possessing  the  power  of  allaying 
vomiting  and  gastric  irritability. 

As  an  antiseptic.  Prof  Lister  regards  carbolic  acid  to  be 
superior  to  all  other  agents,  as  it  is  a  most  potent  poison  to 
all  the  low  forms  of  life  which  determine  putrefaction,  as  it 
retains  this  power,  even  when  diluted  to  such  a  degree  as  to 
be  almost  entirely  unirritating  to  the  tissues  of  the  human 
body.  One  per  cent,  in  strength  is  sufficient  to  destroy  bac- 
teria, vibrios,  etc.  On  account  of  its  volatility,  the  vapor  of 
carbolic  acid  is  also  efficacious  as  an  antiseptic.  As  a  local 
anaesthetic,  it  exerts  a  very  soothing  influence  upon  painful 
tissues ;  hence  it  is  beneficial  in  odontalgia  and  for  pulp  dress- 
ing. On  account  of  its  solubility,  a  variety  of  solutions  of 
special  value  can  be  formed  with  it,  which  are  especially 
serviceable  as  antiseptic  applications. 

The  application  of  large  quantities  of  carbolic  acid  to  an 
extensive  surface  is,  however,  dangerous,  as  cases  of  fatal  pois- 
oning have  resulted  by  the  absorption  of  this  acid ;  hence 
care  is  necessary  in  its  use  as  an  external  application. 

Its  nauseous  odor  and  taste  and  its  caustic  action  render  it 
objectionable,  unless  greatly  diluted,  for  internal  administration. 
To  obviate  such  objections,  it  is  recommended  to  use  it  in  the 
form  of  sulpho-carbolates. 

When  applied  to  the  skin  or  to  mucous  membrane,  it  pro- 
duces a  burning  sensation,  of  short  duration,  and  the  eschar  is 
at  first  whitish,  afterwards  becoming  brown  or  black,  and 
surrounded  by  a  zone  of  inflammatory  redness ;  and,  notwith- 


ACIDUM    CARBOLICUM — CARBOLIC    ACID.  105 


Standing  its  power  to  coagulate  albumen,  is  rapidly  diffused 
into  the  blood.  Carbolic  acid  exists  in  the  blood  as  a  carbo- 
late ;  and  the  blood  itself  does  not  appear  to  undergo  any 
change  in  its  corpuscular  elements.  It  is  in  part  consumed  in 
the  body,  and  the  products  of  its  combustion  are  excreted  in 
the  urine.  Solutions  of  carbolic  acid  of  adequate  strength  will 
check  suppuration,  and  correct  the  fetor  of  ulcers,  etc. 

Therapeutic  Uses.  Internally,  it  is  employed  for  nausea  and 
vomiting  due  to  an  irritable  state  of  the  stomach,  in  scarlatina, 
measles  and  smallpox,  pyrosis,  etc. ;  as  a  gargle  in  diphtheria; 
as  an  inhalation  in  chronic  nasal  catarrh,  hay  asthma,  whoop- 
ing-cough, phthisis,  etc. ;  as  an  injection  in  chronic  cystitis, 
primary  syphilis,  erysipelas,  pleuro-pneumonia  and  uterine  dis- 
eases ;  as  a  lotion  in  gangrenous  and  other  ill-conditioned 
ulcers,  carbuncle,  poisoned  wounds,  burns,  skin  diseases,  scrofu- 
lous ophthalmia  and  itching  of  the  skin. 

Dose.  Of  crystallized  carbolic  acid,  gr.  j  to  gr.  ij,  largely 
diluted.  A  better  form,  however,  is  07ie  drop  of  the  crystallized 
acid,  liquefied  by  heat,  in  one  ounce  of  mucilage,  three  times 
a  day.  The  dose  of  glycerite  of  carbolic  acid  {Glyceritum 
Acidi  Cardolici),  made  by  rubbing  together  Sij  of  carbolic  acid 
with  Oss  of  glycerine,  is  niiv. 

The  dose  of  carbolic  acid  water  {Aqua  Acidi  Carbolici)  f5x; 
of  the  glycerite,  dissolved  in  distilled  water,  enough  to  make 
the  mixture  measure  a  pint,  the  dose  is  foss  to  f5j. 

Impure  carbolic  acid  is  employed  for  disinfectant  purposes. 

Ointment  of  carbolic  acid  {Ungiieiitiim  Acidi  Carbolici) — 
Carbolic  acid,  5j ;  lard,  Sj. 

Sulpho-carbolic  acid  (HC6H5SO4)  is  considered  to  be  a  very 
efficient  antiseptic  and  disinfectant. 

Sulpho-carbolate  of  zinc,  Zn  (C6H5S04)2H20),  combines  the 
virtues  of  zinc  salts  and  carbolic  acid,  and  is  used,  internally,  in 
diarrhoea,  and,  externally,  in  aqueous  solution  of  from  three 
to  six  grains  to  the  ounce,  as  a  dressing  for  wounds  and  ulcers 
and  an  injection  in  gonorrhoea. 

Sulpho-carbolates  of  sodium,  potassium,  magnesium,  calcium 


106  DENTAL    MEDICINE. 

and  quinia  are  employed  as  antiseptics  in  cholera  and  zymotic 
diseases  generally. 

Dental  Uses.  Carbolic  acid  being  antiseptic,  styptic,  eschar- 
otic,  stimulant  and  sedative,  or  narcotic,  is  a  valuable  agent  in 
dental  therapeutics.  When  applied  to  carious  dentine,  it  not 
only  obtunds  sensibility,  but  arrests  putrefactive  changes  in 
the  devitalized  structure,  and  coagulates  the  albuminous  ele- 
ments at  the  ends  of  the  dentinal  tubuli.  It  relieves  odontalgia 
when  applied  to  the  surface  of  an  exposed  and  painful  pulp. 
It  is  also  invaluable  in  the  treatment  of  alveolar  abscess ;  and, 
in  combination  with  iodine  or  other  agents,  it  is  often  em- 
ployed with  beneficial  effects  in  the  treatment  of  dental  perios- 
titis. When  employed  in  the  treatment  of  alveolar  abscess,  as 
an  antiseptic,  although  the  discharge  of  pus  may  be  increased 
for  a  short  time  after  its  application,  there  is  soon  manifested 
a  decided  diminution  in  the  quantity  secreted.  When  applied 
to  a  suppurating  pulp,  it  arrests  putrefaction,  and  induces  a 
healthy  action  without  irritation.  If  is  also  a  valuable  anti- 
septic application  in  ulcerations  of  the  mucous  membrane  of 
the  mouth,  gangrenous  conditions  and  mercurial  stomatitis ; 
for  such  purposes  being  combined  with  glycerine  and  other 
agents.  Applied  to  exposed  pulps,  it  forms,  by  its  escharotic 
action,  an  eschar,  which  some  regard  as  conducive  to  the 
recovery  of  the  organ,  while  others  prefer  to  use  it  in  a 
diluted  form,  for  the  same  object,  objecting  to  its  employ- 
ment in  its  pure  state,  on  account  of  its  escharotic  or  caustic 
effect. 

It  is  also  useful  as  a  styptic  in  cases  of  superficial  hemor- 
rhage from  the  gums  after  the  extraction  of  teeth,  especially 
in  combination  with  other  agents.  A  preparation,  known  as 
phenol  sodigue,  is  often  employed  for  such  a  purpose. 

Oil  of  cloves,  when  added  to  an  equal  quantity  of  carbolic 
acid,  will  disguise,  to  some  extent,  its  taste  and  odor.  It  can 
also  be  perfumed  by  adding  to  i  part  of  carbolic  acid,  3  parts  of 
oil  of  lemon,  and  100  parts  of  alcohol  (36  degrees).  Carbolic 
acid  is  also  employed  to  check  the  hemorrhage  resulting  from 


ACIDUM    CARBOLICUM CARBOLIC    ACID.  107 

the  application  of  leeches  to  the  mucous  membrane  of  the 
mouth.  When  applied  to  an  ulcerated  surface,  it  should  be 
repeated,  as  pus  is  formed  or  fungous  growths  appear ;  and, 
having  formed  an  eschar  when  applied  to  an  exposed  pulp,  it 
should  not  be  repeated  until  the  eschar  is  detached  from  the 
surface.  It  has  also  been  employed  in  the  form  of  hypodermic 
injections,  for  the  relief  of  neuralgia. 

Carbolic  acid  is  also  useful  as  a  local  anaesthetic.  Combined 
with  glycerine  (i  part  to  12  of  glycerine),  it  will  stimulate  the 
mucous  secretion,  and  hence  has  been  applied  to  the  palate,  in 
cases  of  deficiency  of  this  secretion,  to  promote  the  suction  of 
upper  dentures. 

When  properly  diluted  with  alcohol,  it  renders  soft  and 
spongy  gums  firmer  and  less  tender. 

It  will  also  correct  fetor  of  the  breath,  arising  from  carious 
teeth,  smoking,  etc.,  acting  as  a  deodorizer. 

In  all  fetid  discharges  from  the  mouth,  throat,  etc.,  carbolic 
acid,  combined  with  glycerine  or  an  aqueous  solution,  may  be 
used  with  advantage.  Either  pure  or  combined  with  collo- 
dion, it  is  employed  for  bathing  cavities  in  teeth,  preparatory 
to  the  introduction  of  the  filling  material,  for  its  effect  on  sen- 
sitive or  softened  dentine  and  low  organisms. 

DENTAL  FORMULAE. 

A  Disinfectant  Month  Wash.  A  Stimulant  and  Antiseptic  Mouth 

Dr.  J.  B.  Patrick.  Wash. 

R.    Acidi  Carbolici  (Cryst.)  R.    Acidi  Carbolici gtt.  xx 

Glycerini  Glycerini ^iv 

Aquae  Rosae aa ^ij.  M.             Aquae _^  x.         M. 

SiGNA. — Five  to  eight  drops  in  a  wine-     Signa. — To  be  used  as  a  gargle, 
glass  of  water. 

A  Lotioti  for  Soft  and  Spongy  Gums.  A  Stimulant  and  Antiseptic  Lotion. 

R.    Acidi   Carbolici gr.  xx  Dr.  J.  Stocken. 

Spiriti  Rectificati  (Alco-  R.    Acidi  Carbolici ^j 

hoi) I^ij  Glycerini ^iv 

Aquae  Destillatse ^vj.         M.  Aquae g  x.          M. 

It  renders  the  gums  less  tender  and  Useful  in  ulceration  of  the  gums  and 

firmer.  mucous  membrane. 


108 


DENTAL   MEDICINE. 


An  Antiseptic  Lotion  or  Injection. 

U .    Acidi  Carbolici 3  ss 

Glycerini 3  ^v.        M. 

For  alveolar  abscess  and  ulcers  of 
mouth.  The  glycerine  modifies  the 
caustic  action  of  the  acid. 

A  Stimulant  and  Antiseptic  Injection. 

R.    Acidi  Carbolici i  part 

Glycerini 30  parts.  M. 

Useful  as  an  injection  in  chronic 
forms  of  alveolar  abscess. 

An  Antiseptic  and  Disinfectant  Denti- 
frice. 
J.  Stocken. 

U.    Acidi  Carbolici TTLxxx 

Pulveris  Ossis  Sepise...  ^ij 
Pulveris  Radicis  Iridis^ij 

Cretse  PreparatEe ^  iij 

Olei  Caryophylli gtt.  iij.     M. 

For  Odontalgia. 

R.    Collodii  (Flexile) ^j 

Acidi  Carbolici ^ij.  M. 

SiGNA. — Apply  to  surface  of  exposed 
and  painful  pulp. 

For  Odontalgia. 

R.    Acidi  Carbolici ^ij 

Morphinse  Acetatis gr.  xx. 

Solve.     Applied  to  surface  of  exposed 
pulp,  on  cotton. 

For  Odontalgia. 
R .    Acidi  Carbolici 
Chloroform! 
Liquidi  Opii 
Vel  Morphinae  Hydrochlo- 

ratis aa 3  '^ 

Tincturse  Benzoini f^].  M. 

Apply  to  exposed  surface  of  pulp,  on 
cotton. 


A  Stitnulant  and  Antiseptic  Lotion   or 
Injection. 

Percy  Boulton. 

R.    Acidi  Carbolici Tt\^vj 

Tincturse  lodi TTLxlv 

Glycerini ^  j 

Aquse  Destillatse ^v.  M. 

For  inflamed  mucous  membrane,  and 
an  injection  for  chronic  alveolar  ab- 
scess ;  also  useful  in  acute  abscess  after 
the  use  of  more  powerful  escharotic 
and  antiseptic  agents. 

For  Fetid  Perspiration. 

R .    Acidi  Carbolici 2  parts 

Glycerini 3  parts.    M. 

For  Wounds  and  Ulcers,  to  Produce 

an  Antiseptic  Scab. 
R .  Melt  together,  with  a  gentle  heat, 
Stearine,  15  parts;  Rosin,  60  parts; 
and  when  the  mass  has  somewhat 
cooled,  but  is  still  liquid,  add  25 
parts  of  Carbolic  Acid.  This  mix- 
ture is  then  incorporated  with  from 
700  to  800  parts  of  precipitated  Car- 
bonate of  Calcium,  and  carefully  re- 
duced to  a  uniform  powder. 

For  Inhalation  in  Syphilitic  Ulcera- 
tions. 

R.    Acidi  Carbolici ^^xj 

Aquae  Destillatse ^iij-         M. 

SiGNA. — Inhale  the  vapor.     Antiseptic. 

For  Parasitic  Skin  Diseases. 

R .    Acidi  Carbolici ^  j 

Glycerini 5J.  M. 

For  Chilblains. 

R.    Acidi  Carbolici jj 

Tincturse  lodi ^  ij 

Acidi  Tannici ^ij 

Cerat  Simplicis 3  iv.         M . 

Fiat  unguentum. 


ACIDUM    CHROMICUM CHROMIC    ACID. 


109 


For  a  Carbolized  Styptic. 

B .    Acidi  Carbolic! x  parts 

Collodii c  parts 

Acidi  Tannici v  parts 

Acidi  Benzoici v  parts.    M. 

It    coagulates   blood   and    albumen, 
and  cicatrizes  the  tissues. 

For  Alveolar  Pyorrhea    {^Rigg' s   Dis- 
ease). 

R.    Acidi  Carbolici TTLv 

Spts.  Vini  Rectif. ^vj 

Aq.  Menthae  Pip ^ij 

01.  Anisi TT\^j 

01.  Cinnamon n^ss.         M. 

SiGNA. — Apply  to  gum  with  camel's- 

hair  brush. 

For  Alveolar  Pyorrhcea    [Ptgg^s   Dis- 
ease). 

R.    Acidi  Carbolici TTLxxv 

Potassii  lodidi gr.  v 

Zinci  Chloridi gr.  xxv 

Alcohol  Absolut Ti:\^xxv 

Aq.  Destillat3e TTLx 

01.  Menthse  Pip TTLv. 

Misce  et  filtra. 

SiGNA. — As  an  injection  in  pockets 
of  gum. 


For  Itching  of  the  Skin. 

R.    Acidi  Carbolici _^  ij 

Gly  cerini ^^  j 

AquDe  RosEe ,^  ^'ij-       ^^ 

SiGNA. — To  be  applied  by  means  of  a 
sponge. 

The  following  preparation  is  recom- 
mended for  the  relief  of  odontalgia,  by 
Dr.  K.  W.  Millican:— 

"  Melt  white  wax  or  spermaceti,  two 
parts,  and  when  melted  add  carbolic 
acid  crystals,  one  part,  and  chloral  hy- 
drate crystals,  two  parts ;  stir  well  till 
dissolved.  While  still  liquid,  immerse 
thin  layers  of  carbolized  absorbent  cot- 
ton-wool, and  allow  them  to  dry.  When 
required  for  use  a  small  piece  may  be 
cut  off  and  slightly  warmed,  when  it 
can  be  inserted  into  the  carious  cavity 
of  the  tooth,  where  it  will  solidify." 


ACIDUM  CHROMICUM— CHROMIC  ACID. 

Formula,  CrOs. 

Derivation.  Chromic  Acid  is  obtained  in  the  form  of  bril- 
Hant,  deep-red  acicular  crystals,  by  the  reaction  of  strong  sul- 
phuric acid  upon  a  solution  of  bichromate  of  potash.  It  is 
deliquescent,  and  very  soluble  in  w^vLer  and  alcohol,  forming 
an  orange-yellow  solution. 

Medical  Properties  and  Action.  It  is  a  powerful  caustic, 
decomposing  the  tissues  by  rapid  oxidation ;  and,  although  it 
is  very  slow  and  gradual  in  its  action,  yet  it  is  deeply  pene- 
trating, and  when  action  ceases,  sesquioxide  of  chromium  re- 
mains.    So   destructive   is   its   effect,  that  small   animals  are 


110  DENTAL   MEDICINE. 


dissolved  entirely,  bones  and  all,  by  it,  in  fifteen  or  twenty 
minutes.  On  account  of  its  penetrating  deeply,  without  much 
pain,  care  is  necessary  in  its  use,  and  when  used  as  a  caustic, 
the  surrounding  tissues  should  be  well  protected.  The  part 
on  which  it  acts  first  becomes  yellow,  then  brown,  and  ulti- 
mately black,  and  the  eschar  is  detached  in  from  twenty-four 
to  forty-eight  hours.  It  is  a  powerful  oxidizer,  and  gives  up 
its  oxygen  readily  to  organic  matter,  which  it  thus  dissolves. 
When  in  solution,  more  or  less  diluted,  its  action  can  be  modi- 
fied, according  to  the  effect  desired. 

Therapeutic  Uses.  Chromic  acid  is  not  given  internally.  In 
the  form  of  paste,  or  solution  with  water,  it  is  a  valuable  caustic 
in  cancerous  and  other  ulcerations,  malignant  growths,  hemor- 
rhoids, warts,  etc.  Chromic  acid  has  been  employed  with 
good  effect  in  cases  of  secondary  syphilitic  deep  and  jagged 
ulcers  of  the  tongue,  and  ulceration  of  inside  of  the  cheek, 
mucous  tubercles  and  condylomata.  It  has  also  been  em- 
ployed in  the  treatment  of  granular  ophthalmia,  uterine  hem- 
orrhage, uterine  catarrh,  etc.  It  causes  less  pain  than  nitric 
acid  and  other  caustics,  but  should  never  be  applied  to  a  sur- 
face to  be  cauterized  in  a  layer  deeper  than  a  line  in  thickness. 
For  the  removal  of  warts,  etc.,  it  is  employed  in  a  solution  of 
TOO  grains  to  the  ounce  of  distilled  water. 

Defital  Uses.  In  dental  practice  chromic  acid  has  been  em- 
ployed for  obtunding  sensitive  dentine,  and  for  bleaching 
necrosed  teeth ;  but  its  most  valuable  application  is  for  the 
removal  of  tumors  and  morbid  growths  upon  the  gums,  fun- 
gous growths  of  tooth  pulp,  etc.  When  applied  to  any  part  of 
the  mouth,  the  surrounding  parts  should  be  carefully  protected 
by  folds  of  lint  or  strips  of  adhesive  plaster.  A  glass  rod,  or  a 
gold  or  platinum  wire  should  be  used  for  its  application.  It 
is  also  useful  in  ulceration  and  recession  of  the  gums,  begin- 
ning the  treatment  with  a  weak  solution,  and  gradually  in- 
creasing the  strength.  It  is  sometimes  combined  with  gly- 
cerine, in  which  case  the  latter  must  be  added  to  the  acid,  drop 
by  drop,  in  order  to  avoid  explosion. 


ACIDUM    GALLICUM GALLIC    ACID.  Ill 

DENTAL   FORMULA. 

For  Secondary  Syphilitic  Ulcers,  and 
Ulcei-ations  of  Mucous  Membnute  of 
Mouth  and  Tongue. 

R.     Acidi   Chromici gr.  x 

Aquae |j. 

Misce  Solut. 
SiGNA. — Paint  the  diseased  parts  3  or  4 
times  a  day  with  a  camel's-hair  brush 
dipped  in  the  solution. 

ACIDUM  GALLICUM— GALLIC  ACID. 

Formula.     C7H6O5. 

Derivation.  Gallic  Acid  is  obtained  from  galls  by  exposing 
the  powder  in  water  to  the  action  of  the  air,  at  a  temperature 
of  between  60°  and  70°  F.,  when  the  acid  is  deposited  in  the 
form  of  small,  silky,  almost  colorless  crystals,  possessing  a 
slightly  acid  and  astringent  taste.  Gallic  acid  is  slightly  sol- 
uble in  cold  water,  and  freely  soluble  in  hot  water,  glycerine  or 
alcohol. 

Galls,  from  which  gallic  acid  is  prepared,  are  the  excres- 
cences caused  by  the  punctures  and  deposited  ova  of  a  hymen- 
opterous  insect  on  the  twigs  of  the  gall  oak  {jQuercus  Infec- 
torid). 

Source.     Galls  are  obtained  from  Asia  Minor  and  Persia. 

Medical  Properties  and  Actions  of  Galls.  Powerfully  astrin- 
gent, this  property  depending  upon  the  presence  of  tannic  and 
gallic  acids,  as  they  contain  35  per  cent,  of  tannic  and  5  per 
cent,  of  gallic  acids.  The  powder,  which  is  obtained  from  the 
small,  round,  dark-blue  or  lead-colored  excrescences,  is  of  a 
light  yellowish-gray  color,  inodorous  and  of  a  bitter  taste. 

Galls  are  used  in  various  forms,  such  as  powder,  tincture, 
infusion,  ointment,  etc. 

Therapeutic  Uses.  Galls  are  employed  in  the  treatment  of 
chronic  diarrhoea,  dysentery,  leucorrhoea,  chronic  gonorrhoea 
and  gleet,  disease  of  the  uterus  and  intermittent  fevers,  and 
externally  in  hemorrhagic  disorders,  hemorrhoids,  relaxation 
o    uvula,  hypertrophy  of  the  tonsils,  etc. 

Dose.     Of  Powdered  Galls,  gr.  x  to  gr.  xx.     The  ointment 


112  DENTAL    MEDICINE. 


is  composed  of:  Powdered  Galls,  gr.  Ixxx;  benzoated  lard,  Sj. 
It  is  combined  with  opium  in  the  proportion  of  Omtment  of 
Galls,  Sj ;  Powdered  Opium,  gr.  xxxij. 

Medical  Pi^operties  ajid  Actions.  Gallic  acid  is  a  powerful 
astringent  for  arresting  hemorrhage,  in  which  the  bleeding 
vessels  must  be  reached  through  the  circulation.  It  is  also  a 
valuable  styptic  in  cases  of  hemorrhage  depending  on  a  hemor- 
rhagic diathesis,  and  in  the  form  of  a  gargle  it  is  very  service- 
able in  acute  inflammations  of  mucous  membranes.  It  is  also 
a  strongly  deoxidizing  agent ;  and,  like  tannic  acid,  it  is  cap- 
able of  taking  oxygen  from  the  globules.  Internally  employed 
it  produces  constipation,  which  may  be  prevented  by  an  occa- 
sional aperient.  Although  it  is  weaker  than  tannic  acid,  yet 
its  properties  are  very  similar.  It  is  supposed  to  be  converted 
into  tannic  acid  in  the  blood. 

Therapeutic  Uses.  Gallic  acid  is  employed  in  the  treatment 
of  hemorrhagic  diseases,  in  their  chronic  stages  especially, 
such  as  haemoptysis,  hemorrhage  from  ulcer  of  the  stomach, 
haematemesis  and  haematuria,  atonic  menorrhagia ;  also,  for 
the  profuse  perspirations  and  excessive  expectoration  of 
phthisis,  albuminuria,  dyspepsia,  chronic  diarrhoea  and  gastric 
irritation  in  children,  gonorrhoea,  gleet,  etc. 

Dose.  Of  Gallic  Acid,  gr.  ij  to  gr.  v,  in  pill,  every  two  or 
three  hours. 

Glycerite  of  Gallic  Acid  [Glyceritum,  Acidi  Gallici),  for 
eikternal  use,  is  composed  of  Gallic  Acid,  Sj ;  Glycerine, 
Siv. 

Ointment  of  Galls  {Unguentiim  Gallce),  is  composed  of 
Galls  in  fine  powder,  5j ;  lard,  420  grains. 

Dental  Uses.  Powdered  galls  is  useful  as  a  styptic  in 
superficial  hemorrhages  from  the  gums  and  mucous  mem- 
brane ;  also  in  inflamed  and  ulcerated  conditions  of  mucous 
membrane,  and  in  relaxation  of  the  uvula.  Gallic  acid,  in  the 
form  of  a  gargle,  is  employed  in  acute  inflammations  of  mu- 
cous membrane,  as  astringent  and  antiseptic,  and  in  hemor- 
rhages from  mucous  surfaces  depending  upon  a  hemorrhagic 
diathesis. 


ACIDUM    HYDROCHLORICUM HYDROCHLORIC    ACID.        113 

DENTAL  FORMULAE. 

For  an  Astringent  Gargle  or  Lotion.  For  Relaxation  of  Uvula   and  Hyper- 

R.     Pulveris  Gallas ^ss  trophy  of  To7isils. 

Aquas Oj.  M.  R.     Infusi  Gallce 5VJ 

SiGNA. — As  a    gargle  or  lotion  in   in-  Aluminis gr.  xl.       M. 

flamed  or  ulcerated  conditions  of  mu-  SiGNA. — Use  as  a  gargle, 
cous  membrane  and  gums. 

For  Acute  Tonsillitis  and hiflatnjnaiion  An    Internal    Astringent     in  Hemor- 
of  Mucous  Membrane  of  the  Mouth.  rhagic  Affections. 

R.     Acidi  Gallici gr- xl  R-     AcidiGallici gj 

Liq.  Sodse  Chlorinatae..^  ij  Glycerini   _^  iv 

Glycerini ^ij  Aquee  Destillatas ^vj.         M. 

Aquas  Destillatae ,1  viij.       M.  Signa. — Take  ^j  as  a  dose. 

SiGNA. — To  be  used  as  an  antiseptic  and 
astringent  gargle. 

ACIDUM    HYDROCHLORICUM— HYDROCHLORIC 

ACID. 
Muriatic  Acid — Acidum  Muriaticum. 

Formula.     HCl.     Sp.  gr.  1.16. 

Derivation.  Hydrochloric  or  muriatic  acid  is  obtained  by 
the  action  of  sulphuric  acid  on  a  solution  of  chloride  of 
sodium  or  common  salt.  When  pure,  it  is  a  transparent,  color- 
less liquid,  but  when  contaminated  with  chlorine,  iron  and 
other  substances,  it  has  a  yellow  color.  It  emits  a  dense,  white 
vapor,  with  a  pungent  odor  and  a  corrosive  taste,  being  an 
active  poison.     The  antidote  is  magnesia  or  soap. 

Medical  Properties  and  Actions.  The  strong  acid  is  a  pow- 
erful caustic  and  escharotic  ;  also  disinfectant  and  fumigant, 
but  inferior  in  its  disinfectant  properties  to  those  of  chlorine. 
For  internal  use  the  dilute  acid,  which  is  tonic,  refrigerant  and 
astringent,  is  employed,  acidum  hydrochlorium  dilutum — 
diluted  hydrochloric  acid,  which  is  prepared  by  diluting  the 
strong  acid  so  that  four  ounces  of  the  acid  are  contained  in  a 
pint  of  diluted  acid.  It  is  of  a  deep  yellow  color,  and  emits 
the  odor  of  chlorine,  which  is  its  principal  constituent. 

Therapeutic  Uses.  The  dilute  hydrochloric  acid  is  inter- 
nally employed  in  the  treatment  of  calculous  affections,  gout, 
atonic  dyspepsia,  typhus  and  typhoid  fevers,  continued  fevers 


114  DENTAL   MEDICINE. 


of  childhood,  syphihs,  chronic  whooping  cough,  phthisis,  etc., 
and  externally"  in  diphtheria,  ulcerated  sore  throat,  cynanche 
maligna,  etc. 

Dose.  Of  Dilute  Hydrochloric  Acid,  \\yL  to  n\^xxx,  freely 
diluted ;  otherwise,  when  swallowed,  it  is  highly  irritant  and 
corrosive. 

Dental  Uses.  The  strong  acid  is  employed  in  the  dental 
laboratory  for  dissolving  zinc,  in  the  preparation  of  a  flux  for 
soldering  certain  metals. 

The  strong  acid  is  also  employed  as  a  local  application,  in 
gangrenous  stomatitis  or  cancrum  oris,  for  arresting  the  ulcera- 
tive process ;  but  care  is  necessary  in  its  use,  on  account  of  its 
powerful  action,  in  order  to  limit  its  application  to  the  parts 
on  which  it  is  to  act.  In  mild  cases  it  should  be  diluted  with 
an  equal  weight  of  honey. 

In  aphthous  ulcerations  of  the  mouth  in  children  it  is  often  a 
useful  application. 

DENTAL  FORMULA. 
For  Aphtha.  For  Ulcerations  of  Mucous  Metttbrane. 

R.    Acidi  Hydrochlorici...!  part  R .    Acidi     Hydrochlorici 

Mellis 8  parts.    M.  Diluti gij 

SiGNA. — Apply  with  a  camel-hair  pen  Glycerini ^iv 

cil.  Aquae  Destillatae ^  x.         M. 

SiGNA. — To  be  used  as  a  gargle. 

For  Chronic  Inflammation  of  Mucous  For  Sco7-butic  Gums. 

Membraiie  and  Gums.  jj .    Acidi  Hydrochlorici 

R.    Acidi  Hydrochlorici  Dilut ^ss 

Dilut n\^x  Mellis 

Infusi  Cinchonas f.^iv  Aquee  Rosge aa f^j-  M. 

Mellis f^j.  M.     SiGNA. — Apply  with  a  camel-hair  pen- 

Fiat  gargarysma.  cil  three  or  four  times  a  day. 

ACIDUM  NITRICUM— NITRIC  ACID. 

Aqua  Fortis. 

Fonnula.     HNO3.     Sp.  gr.  1.420. 

Derivation.  Nitric  acid  is  obtained  by  the  action  of  sul- 
phuric acid  upon  nitrate  of  potash  or  soda.  When  strong  and 
pure  it  is  colorless,  but  on  account  of  the  presence  of  nitric 


ACIDUM    NITRICUM NITRIC    ACID.  115 

peroxide  it  is  generally  of  a  yellow  color,  and  emits  acrid 
corrosive  fumes. 

Medical  Properties  and  Action.  Pure  nitric  acid  is  a  power- 
ful caustic  and  escharotic,  and  leaves  a  permanent  stain  on  the 
cuticle.  It  is  not  employed  in  its  concentrated  form  internally, 
but  externally,  as  an  escharotic  to  destroy  warts  and  stimulate 
sluggish  sinuses ;  in  a  diluted  form  it  is  employed  as  an 
astringent  wash  or  gargle.  The  antidotes  in  cases  of  poisoning 
are  magnesia  or  soap,  and  mucilaginous  drinks. 

Tlierapeutic  Uses.  The  strong  acid  is  employed  externally 
in  hospital  gangrene  and  phagedenic  ulcerations ;  hemor- 
rhoids and  painful  hemorrhoidal  tumors,  syphilitic  condylo- 
mata, syphilitic  sore  throat,  malignant  ulcers,  obstinate  skin 
diseases,  etc. 

Diluted  Nitric  Acid — Acidjun  Nitricnm  Diliitum,  con- 
tains three  ounces  of  acid  in  a  pint  of  the  diluted  acid. 

Medical  Properties  and  Action.  It  is  an  antalkaline,  altera- 
tive, tonic  and  refrigerant,  and  has  a  very  direct  action  on  the 
liver,  and  if  its  use  is  continued  for  a  long  time  it  causes  sali- 
vation. Like  all  mineral  acids,  it  injures  the  teeth  ;  hence, 
proper  care  should  be  taken  to  prevent  such  action — such  as 
the  use  of  alkaline  gargles  before  and  after  taking  the  acid 
into  the  mouth,  which  should  be  done  through  a  glass  tube  or 
quill.  As  a  tonic  it  is  advantageously  employed  during  con- 
valescence after  inflammation,  and  in  cachexia  following  acute 
disease  or  habits  of  intemperance.  It  is  also  employed  as  an 
alterative  after  the  long  use  of  mercury,  as  it  increases  the 
strength  and  improves  the  tone  of  the  system.  It  is  also 
valuable  as  a  disinfectant,  but  inferior  to  chlorine.  It  is  not  as 
agreeable  to  the  stomach  as  diluted  sulphuric  acid. 

Tlierapeutic  Uses.  Dilute  nitric  acid  is  employed  in  the 
treatment  of  calculous  disease,  syphilis,  chronic  hepatitis, 
chronic  diarrhoea,  constipation,  chronic  affections  of  the  spleen, 
chronic  rheumatism,  cardialgia,  whooping  cough,  intermittent 
fevers,  etc. 

Dose.  Of  diluted  nitric  acid,  gtt.  ij-xv,  three  times  a  day, 
diluted  with  water. 


116  DENTAL    MEDICINE. 


Dental  Uses.  The  strong  acid  when  mixed  with  two  parts 
of  hydrochloric  acid,  is  a  solvent  for  gold,  and  is  known  as 
aqua  regia.  It  is  also  employed  as  one  of  the  most  effectual 
caustics  in  cancrum  oris,  the  constitution  being  supported  and 
quinine  given  at  the  same  time;  also  for  malignant  ulcers  of 
the  mouth,  and  for  devitalizing  pulps  of  teeth  when  nearly  ex- 
posed by  mechanical  abrasion,  care  being  observed  that  the 
part  of  the  surface  immediately  over  the  pulp  is  touched  with 

the  acid,  and  the  neighboring  parts  protected. 

* 
DENTAL  FORMULA. 

For  Sloughing  and  III- Conditioned  Ulcers. 

B.    Acidi  Nitrici .rt\^l-lx 

Aquse Oj.  M. 

SiGNA. — Apply  with  a  camel-hair  brush. 

ACIDUM  PHOSPHORICUM— PHOSPHORIC  ACID. 

AciDUM  Phosphoricum  Dilutum — Diluted  Phosphoric  Acid, 
is  the  principal  form  in  which  phosphoric  acid  is  employed 
in  medicine. 

Forimda.     H3PO4.     Sp.  gr.  1.056. 

Derivation.  Phosphorus,  a  non-metallic  element,  obtained 
from  bones,  is  a  translucent,  nearly  colorless,  wax-like  solid, 
without  taste,  and  emitting  white  vapors  when  exposed  to  the 
air.     Sp.  gr.  1.8. 

It  is  insoluble  in  water,  but  soluble  in  ether  and  in  hot  oil 
of  turpentine,  and  has  a  peculiar  smell.  It  is  nervine,  tonic 
and  stimulant,  and,  in  over-doses,  poisonous.  The  vapor  is 
irritating  to  the  conjunctiva  and  bronchial  mucous  membrane. 

Derivation.  Diluted  Phosphoric  Acid  is  prepared  by  boiling 
phosphorus  with  nitric  acid  and  distilled  water  until  it  is  dis- 
solved, evaporating  and  re-diluting  it.  Tt  may  also  be  obtained 
by  dissolving  an  ounce  of  glacial  phosphoric  acid  in  three 
ounces  of  distilled  water,  afterwards  adding  forty  grains  of 
nitric  acid,  boiling  to  a  syrup,  and  diluting  with  water  until 
the  solution  measures  twelve  and  a  half  ounces. 

Medical  Properties  and  Action.  It  is  tonic  and  refrigerant, 
and,  in  large  doses,  is  a  powerful  stimulant  of  the  nervous  and 


ACIDUM    PHOSPHORICUM PHOSPHORIC    ACID.  117 

vascular  systems.  It  can  be  detected  in  the  blood,  owing  to 
its  absorption,  and,  in  large  doses,  is  an  irritant  poison. 

Therapeiitic  Uses.  Diluted  phosphoric  acid  is  employed  in 
scrofula,  dropsy,  hsemoptysis,  calculous  disease,  diabetes  and 
cardialgia.  Externally,  it  has  been  employed  as  a  local  appli- 
cation in  the  treatment  of  caries  of  the  bones  and  osseous 
tumors. 

Dose.  Of  diluted  phosphoric  acid  gtt.  ij-xv,  diluted  in  sugar 
and  water. 

Dental  Uses.  As  a  local  application  in  the  treatment  of 
caries  of  the  maxillary  bones  and  osseous  tumors  of  the  jaws. 
Internally,  it  has  been  administered  with  a  view  of  supplying 
a  deficiency  of  phosphoric  acid  in  the  teeth.  (See  Hypophos- 
phites  of  Lime}) 

DENTAL  FORMUL.^. 

For  Caries  of  the  Maxillary  Bones  and  For  Ulcers  over  Carious  Bones, 

for  Osseous  Tumors  of  the  Jaw.  g,    Acidi   Phosphorici 

R.    Acidi  Phosphor.  Dilut.. I  part  Glacialis 3;j 

Aquae  DestillatcC.S  to  lo  parts.  M.  Aquse  Destillatoe f^viij. 

SiGNA. — Apply  as  a  lotion  or  injection.         Fiat  solutio. 

SiGNA. — To  be  applied  on  compresses 
to  ulcers  situated  over  carious  bones. 

Phosphoric  Acid  in  the  anhydrous  state  consists  of  one 
equivalent  of  phosphorus  to  five  equivalents  of  oxygen  (PO5), 
and  is  obtained  by  the  direct  union  of  its  constituents,  which 
takes  place  when  phosphorus  is  burned  in  perfectly  dry 
oxygen  gas. 

Thus  procured,  it  is  in  the  form  of  a  white  amorphous  pow- 
der, extremely  deliquescent,  volatilizable  at  a  red  heat,  and 
assumes,  when  it  cools,  after  fusion,  a  vitreous  appearance. 

Glacial  Phosphoric  Acid,  or  monohydrated  phosphoric  acid, 
is  readily  obtained  from  calcined  bones,  by  first  treating  them 
with  sulphuric  acid,  which  produces  an  insoluble  superphos- 
phate of  lime ;  then  dissolving  out  the  latter  salt,  and  saturating 
it  with  carbonate  of  ammonia,  which  generates  phosphate  of 
ammonia  in  solution,  and  finally  obtaining  the  phosphate  of 


118  DENTAL    MEDICINE. 


ammonia  by  evaporating  to  dryness,  and  then  igniting  it  in  a 
platinum  crucible.  The  ammonia  and  all  of  the  water,  except 
one  equivalent  for  each  equivalent  of  the  acid,  are  driven  off, 
and  the  glacial  phosphoric  acid  remains,  the  formula  of  which 
is  HOjPOs,  and  contains  11.2  per  cent,  of  water.  It  is  a  white, 
transparent,  fusible  solid,  generally  in  the  form  of  sticks,  inodor- 
ous and  sour  to  the  taste.  It  slowly  deliquesces,  and  is  spar- 
ingly soluble  in  water,  but  freely  soluble  in  alcohol. 

Dental  Uses.  Glacial  phosphoric  acid  and  white  oxide  of 
zinc  formed  into  an  anhydrate  give  the  plastic  material  for 
filling  teeth  known  as  oxy-phosphate  of  zinc.  The  powder  or 
solid  portion  of  this  preparation  is  prepared  by  packing  pure 
oxide  of  zinc  in  a  clay  crucible  and  subjecting  it  to  almost  a 
white  heat  for  two  hours,  when  it  will  have  been  reduced  in 
bulk  fifty  per  cent.  It  is  then  pulverized  in  a  mortar,  to  an 
almost  impalpable  powder.  The  burning  of  the  oxide  of  zinc 
colors  it  to  a  light  yellow,  and  it  is  now  in  a  condition  for  use, 
and  may  be  kept  in  a  covered  vessel  for  any  length  of  time. 

The  liquid  portion  of  this  filling  material  being  glacial  phos- 
phoric acid,  it  is  dissolved  in  pure  water  until  a  saturated 
solution  is  obtained,  when  it  is  reduced  by  boiling  in  a  glass 
vessel  until  it  is  of  the  consistency  of  glycerine,  in  which 
operation  it  loses  one-third  in  bulk.  It  is  now  ready  for  use, 
and  must  be  kept  in  a  close  glass-stoppered  bottle. 

Formula  for  Fletcher's  and  Weston's  preparations  of  oxy- 
phosphate  of  zinc  filling  materials  : 

Fletcher's. 
Fluid.  Solid. 

Phosphoric  Acid.  Basic  Oxide  of  Zinc. 

Phosphate  of  Alumina. 

Weston's 
Fluid.  Solid. 

Phosphoric  Acid.  Basic  Oxide  of  Zinc — 80  per  cent. 

(See  Oxide  of  Zinc).  Silicate  of  Alumina — 20    "     " 


ACIDUM    SALICYLICUM SALICYLIC    ACID.  119 

, m 

ACIDUM  SALICYLICUM— SALICYLIC  ACID. 

Formula.     HC7H5O3  or  C6H4  \  oooh  |- 

Derivation.  Salicylic  acid  is  obtained  by  combining  car- 
bolic acid  with  caustic  soda,  and  subjecting  this  compound  to 
dry  carbonic  acid  under  the  influence  of  heat,  the  portion  of 
salicylate  of  sodium  remaining  behind  after  the  carbolic  acid 
distills  over,  being  saturated,  in  the  form  of  a  hot  aqueous 
solution,  with  muriatic  acid,  which  liberates  the  salicylic  acid 
in  small  crystals.  The  crystals  are  washed,  dissolved  in  hot 
water,  and  byre-crystallization,  obtained  in  the  form  of  a  powder 
of  a  light  brown  color,  which  is  then  bleached  until  it  is  quite 
white ;  but  most  of  that  sold  is  of  a  light  cream  color,  with  a 
reddish  tinge.  The  coloring  matter,  however,  which  is  present, 
does  not  interfere  with  its  efficacy.  It  has  no  smell,  a  slight 
taste,  and  is  soluble  in  alcohol  and  ether  and  in  hot  water  and 
glycerine.  It  can  also  be  obtained  from  salicin,  the  vegetable 
principle  existing  in  willow,  poplar,  etc.,  and  from  oil  of  gaul- 
theria  (winter  green),  and  from  spiraea  ulmarise  (meadow 
sweet). 

Medical  Propej'ties  and  Action.  Salicylic  acid  is  a  powerful 
antiseptic,  and  is  said  to  be  far  more  effective  in  smaller  quan- 
tities than  any  other  antiseptic,  in  arresting  the  putrefactive  and 
fermentative  processes.  When  properly  reduced  in  strength, 
it  causes  no  pain  or  irritation  in  the  parts  to  which  it  is  applied. 
It  will  destroy  minute  organisms,  and  a  small  quantity  will 
arrest  vinous  fermentation  and  prevent  the  decomposition  of 
animal  fluids.  Although  free  from  any  poisonous  action  when 
administered  in  a  reasonable  quantity,  yet,  in  large  doses,  it 
will  cause  nausea  and  vomiting.  It  is  thought  to  combine 
with  the  soda  of  the  blood,  where  it  is  present  as  a  salicylate. 
It  has  little  or  no  affinity  for  cold  water,  but  the  addition  of 
certain  alkaline  salts,  such  as  sodium  phosphate,  increases  its 
solubility.  Combined  with  sulphite  of  sodium,  which  is  also 
antiseptic,  and  water,  a  solution  is  formed  which  is  free  from 
irritating  properties,  and  especially  applicable  to  the  treatment 
of  zymotic    diseases.     Glycerine    warmed  will    dissolve  -sV  of 


120  DENTAL    MEDICINE. 


its    weight  of  salicylic    acid,  and  the    solution    may  then  be 
diluted  with  water  to  any  desirable  extent. 

Therapeutic  Uses.  It  is  employed  in  fevers  as  an  antipyretic 
or  febrifuge  ;  also  for  the  same  purpose  in  acute  rheumatism, 
pneumonia,  phthisis,  diphtheria,  etc.  Externally  it  is  employed 
as  a  disinfectant  and  deodorizer,  many  preferring  it,  on  account 
of  its  freedom  from  odor,  to  carbolic  acid.  It  is  also  employed 
as  a  local  application  in  eczema  of  the  head  and  face,  syphilitic 
ulcers,  and  to  cancer,  gangrenous  and  sloughing  wounds,  in 
the  form  of  powder,  and  as  an  ointment  for  burns. 
Dose.  Of  salicylic  acid,  gr.  x  to  gr.  xx  or  xxx. 
Dental  Uses.  Salicylic  acid  is  employed  in  the  treatment  of 
suppurating  and  gangrenous  pulps  of  teeth,  in  the  form  of  the 
dry  powder  introduced  into  the  pulp  canals  and  permitted  to 
remain  for  several  days.  An  ethereal  solution  of  salicylic  acid 
introduced  on  a  small  piece  of  spunk,  has  also  been  employed 
for  the  same  purpose,  where  it  is  difficult  to  introduce  the  dry 
powder ;  the  ether  volatilizes  in  a  few  minutes.  Salicylic  acid 
is  also  employed  with  advantage  in  inflamed  conditions  of  the 
mucous  membrane  of  the  mouth  and  gums,  and  in  the  treat- 
ment of  aphthse,  thrush  and  other  ulcers,  in  the  form  of  a  solu- 
tion. For  such  purposes  its  combination  with  powdered 
cassia  or  cinnamon,  equal  parts,  is  recommended,  to  be  applied 
with  a  soft  brush.  Salicylic  acid  has  also  been  found  effica- 
cious in  all  inflammatory  conditions  resulting  from  decayed 
and  dead  teeth  and  roots.  It  has  also  been  recommended  as  a 
dentifrice  in  the  form  of  an  alcoholic  solution  of  the  acid  per- 
fumed with  oil  of  gaultheria,  but  its  use  for  such  a  purpose  is 
questioned,  on  account  of  its  softening  effect  upon  the  tooth 
structure.  As  tannic  acid  interferes  with  the  action  of  sali- 
cylic acid,  these  agents  should  not  be  used  in  combination. 

DENTAL  FORMULA. 

A  Disinfectant  Mouth  Wash.  A  Disinfectant  and  Sti?nulaut  Mouth 

R.     Acidi  Salicylici i  part  Wash. 

Sodii  Phosphate 3  parts  R.    Acidi  Salicylici gij 

Aquae  Destillatae 30  parts.  M.  Spirit!  Vini  Rectificati  5  x.         M. 

SiGNA. — Use  as  a  gargle.  Signa. — Use  as  a  gargle. 


ACIDUM    SULPHURICUM SULPHURIC   ACID.  121 

For  Perspiration  of  Hands  and  Feet.  For  Burns. 

R.     Acidi  Salicylici 3  parts  R.     Acidi  Salicylici _^j 

Magnesii  Silicat 87  parts.  M.  OleiOlivre o  ^^'j-      ^• 

SiGNA — Use  in  the  form  of  a  powder.  Signa. — Apply  as  a  lotion. 

An  Fniollient  and  Antiseptic  Gargle. 

R.    Acidi  Salicylici J^ij 

Sodii  Boratis ^^iij 

Gly  cerini .5  ij  ss 

Aquae  Destillatae 5  iij-      M. 

Signa. — Add  one    or  two   drachms  to 
half  a  pint  of  warm  water. 

ACIDUM  SULPHURICUM— SULPHURIC  ACID. 
Oil  of  Vitriol. 

Formula.     H2  SO4.     Sp.  gr.  1.843. 

Derivation.  Sulphuric  acid  is  obtained  by  burning  sulphur, 
mixed  with  one-eighth  of  its  weight  of  nitre,  over  a  stratum  of 
water  contained  in  a  chamber  lined  with  lead.  It  is  a  dense, 
colorless  liquid,  inodorous,  with  an  acrid  taste,  oily  consistence 
and  very  corrosive.  On  the  addition  of  water,  with  which  it 
unites  in  all  proportions,  there  is  an  evolution  of  heat.  In  the 
concentrated  form  it  is  only  used  externally  as  a  caustic. 
Being  an  acrid,  corrosive  poison,  it  causes  death  from  asphyxia. 
The  antidote  is  magnesia  or  chalk,  or  solution  of  soap,  and 
mucilaginous  drinks  freely  administered. 

Medical  Properties  and  Action.  It  is  a  powerful  escharotic, 
and  when  applied  to  living  tissue,  the  parts  first  become  white, 
and  subsequently  a  brownish  black  color.  It  is  not  used  in- 
ternally, on  account  of  its  corrosive  action.  It  is  considered 
to  be  one  of  the  most  effective  caustics  in  the  bites  of  rabid 
animals. 

Diluted  Sulphuric  Acid — Aciditm  Siilplmriciun  Dihitinn. 

Derivation.  It  is  prepared  by  diluting  sulphuric  acid  fSvij 
with  distilled  water  folxxvij,  and  when  the  mixture  has  cooled 
to  60°,  adding  more  water  olxxxiiiss.     Sp.  gr.  1.094. 

Medical  Properties  and  Action.     It  is  refrigerant,  astringent 
and  tonic.     It  is  employed  as  a  refrigerant  in  fevers ;  as  an 
astringent  for  arresting  hemorrhage  and  passive  mucous  dis- 
charges ;  and  as  a  tonic  to  improve  digestion.    As  it  is  very  in- 
7 


122  DENTAL    MEDICINE. 


jurious  to  the  teeth,  the  proper  precautions  should  be  observed, 
as  in  the  case  of  all  acids  administered  as  medicines — such  as 
alkaline  gargles  used  before  as  well  as  after  their  introduction 
into  the  mouth,  and  the  use  of  a  glass  tube  or  quill. 

Therapeutic  Uses.  Diluted  sulphuric  acid  is  employed  as  an 
internal  remedy  in  hemorrhage  from  the  lungs,  bowels  and 
uterus,  in  calculous  affections,  certain  skin  diseases,  diarrhoea, 
profuse  perspiration  of  phthisis,  in  the  advanced  stages  of 
typhus  and  typhoid  fevers,  scarlatina,  lead  poisoning,  etc. 
Externally,  as  a  gargle  and  wash  to  ulcers. 

Dose.  Of  diluted  sulphuric  acid,  Tr^v  to  n^xx.,  three  times 
a  day  in  water. 

Aromatic  Sulphuric  Acid — Aciduin  Sidplmriciiui  Aromati- 
cum — Elixir  of  Vitriol. 

Derivation.  Aromatic  sulphuric  acid  is  prepared  by  mixing 
sulphuric  acid,  fSiij,  with  rectified  spirit,  Oij,  and  adding  cin- 
namon, oij,  and  ginger,  Sj/^^.  It  is  a  reddish-brown  liquid, 
with  an  aromatic  odor  and  a  pleasant  taste. 

Medical  Properties  and  Action.  It  is  tonic  and  astringent, 
and  is  the  most  agreeable  form  of  sulphuric  acid  for  internal 
use. 

Therapeutic  Uses.  Aromatic  sulphuric  acid  is  employed  as 
a  substitute  for  the  diluted  form  in  debility  with  night  sweats, 
loss  of  appetite  during  convalescence  from  fevers,  haemoptysis 
and  other  hemorrhages  and  epidemic  dysentery.  Externally, 
it  is  applied  to  carious  bone,  ulcers,  etc. 

Dose.  Of  aromatic  sulphuric  acid,  rr^v  to  rr^x^x,  three  times 
a  day,  in  water. 

Dental  Uses  of  the  Different  Fomns  of  Sulphuric  Acid.  The 
concentrated  sulphuric  acid  is  employed  as  a  caustic  in  malig- 
nant ulcers,  cancrum  oris,  gangrene,  etc.,  in  the  form  of  a  paste, 
made  by  mixing  it  with  powdered  sulphate  of  zinc.  The  con- 
centrated sulphuric  acid  is  also  used  in  the  dental  laboratory, 
to  cleanse  metal  plates,  preparatory  to  and  after  soldering,  for 
which  purpose  it  is  generally  diluted  with  one-third  of  water, 
its  action  being  greater  when  it  is  in  a  warm  state.  The  con- 
centrated acid  is  also   used  in  combination  with  nitric  acid, 


ACIDUM    SULPHURICUM SULPHURIC    ACID.  123 

to  reduce  hemp  paper  to  pyroxylin,  in  the  preparation  of  the 
celhiloid  base. 

The  aromatic  sulphuric  acid  is  similar  in  its  action  to  the 
diluted  form,  and  is  more  agreeable  for  use  about  the  mouth. 

It  is  a  valuable  application  in  pyorrhoea  alveolaris  (Riggs' 
disease),  and  in  caries  and  necrosis  of  the  maxillary  bones,  as 
an  injection  or  lotion,  as  it  stimulates  the  parts  to  healthy 
action  by  favoring  granulation.  It  may  be  applied  to  parts 
about  the  teeth,  in  cases  of  recession  of  the  gums  and  absorp- 
tion of  the  processes,  on  a  properly-shaped  piece  of  orange 
wood.  It  is  also  valuable  in  alveolar  abscesses  as  an  injection, 
especially  in  sluggish  cases,  when  the  addition  of  a  few  drops 
of  tincture  of  capsicum  will  prove  serviceable.  It  has  the 
power  of  dissolving  the  thin  carious  portions  of  the  bones, 
such  as  the  margins  of  the  alveolar  cavities,  and  can  be  applied 
on  cotton  saturated  with  it  and  permitted  to  remain  for  several 
hours,  when  the  parts  should  be  perfectly  cleansed  with  warm 
water.  It  is  also  employed  as  a  gargle,  properly  diluted,  in 
mercurial  inflammation  of  the  mouth  and  other  forms  of  sto- 
matitis, which  do  not  yield  to  the  influence  of  milder  astringent 
washes.  It  is  also  employed  in  the  treatment  of  aphthae  and 
other  ulcers  of  the  mouth. 

DENTAL  FORMULA. 

For  Mercurial  and  Ulcerative  Stomatitis.    For  Aphthcz  and  other  Ulcers  of  AIiicous 
Thomas.  Membrane  and  Gums. 

R.     Acidi  Sulphurici IT^x  R.     Acidi  Sulphurici f^ss 

Decocti  Hordei f^iv  Mellis £5].  M. 

Mellis f .1  ss.         M.     Signa. — To  be  applied  with  a  camel- 

SlGNA. — Use  as  a  gargle.  haii-  brush. 

For  Carious  Bone,  Rigg' s  Disease,  etc. 

R.     Acidi  Sulphurici  Aromat f  H  ^'J 

Tinctura  Capsici gtt.  x 

Aqute f^ij-     M. 

Signa. — To  be  used  as  an  injection  or  lotion. 


124  DENTAL   MEDICINE. 


ACIDUM  TANNICUM— TANNIC  ACID. 
Tannin. 

Formula.     C27H22O17. 

Derivation.  Tannic  acid  is  obtained  by  exposing  powdered 
galls  to  a  damp  atmosphere  for  several  days,  when  sufficient 
ether  is  added  to  form  a  soft  paste,  which  is  allowed  to  stand 
for  twenty-four  hours.  It  is  then  subjected  to  pressure  as 
quickly  as  possible,  and  the  mass  again  treated  with  ether,  to 
which  16  of  its  bulk  of  water  has  been  added ;  this  is  allowed 
to  stand  as  before,  and  is  again  subjected  to  pressure.  The 
expressed  liquids  are  now  combined  and  allowed  to  evaporate 
spontaneously ;  then,  by  the  aid  of  a  little  heat,  brought  to  a 
syrupy  consistence,  when  it  is  dried  on  plates  in  a  hot  air 
chamber,  at  a  temperature  not  exceeding  212°  F.  Pure  tannic 
acid  is  solid,  uncrystallizable,  either  white  or  slightly  yellowish, 
inodorous,  astringent  to  the  taste,  but  without  bitterness,  and 
with  an  acid  reaction.  It  is  obtained  in  the  form  of  vesicular 
masses,  or  thin,  glistening  scales,  or  in  the  shape  of  fine  threads 
of  a  pseudo-crystalline  appearance.  Tannic  acid  exists  also  in 
rhatany,  catechu,  and  other  vegetable  astringents,  as  it  is  their 
chief  principle. 

Medical  Properties  and  Actions.  Tannic  acid  is  considered  to 
be  the  most  active  of  all  vegetable  astringents  and  styptics,  and 
especially  powerful  on  albumen,  gelatin  and  fibrin.  It  is  very 
soluble  in  water,  and  less  so  in  alcohol  and  ether.  Taken 
internally,  it  produces  no  nausea,  is  perfectly  safe,  and  its  use 
may  be  continued  for  a  long  time  without  any  ill  effects.  It 
may  also  be  administered  before  and  after  meals,  at  all  times, 
and  be  combined  with  many  other  remedies,  such  as  iron,  cod- 
liver  oil,  bitters,  etc.  Like  gallic  acid,  it  is  capable  of  taking 
oxygen  even  from  the  blood  globules,  when  in  contact  with 
alkalies. 

Tannic  acid  unites  with  albumen,  fibrin  and  gelatin,  forming 
insoluble  tannates,  thus  preserving  the  parts  beneath  from  the 
influence  of  irritating  agents  until  resolution  occurs. 

Its  solution  reddens  litmus  paper,  and  it  is  decomposed  and 
entirely  dissipated  when  thrown  upon  red-hot  iron. 


ACIDUM    TANNICUM TANNIC    ACID.  125 

Therapeutic  Uses.  Internally  it  is  administered  in  hemor- 
rhages of  the  lungs,  stomach,  kidneys  or  uterus,  chronic  bron- 
chial catarrh,  phthisis,  after  softening  has  taken  place,  inter- 
mittent fever,  whooping  cough,  chronic  diarrhoea,  diseases  of 
the'genito-urinary  organs,  dyspepsia,  diphtheria,  nervous  dis- 
eases, etc.  Externally  it  is  applied  in  hemorrhages  and  pro- 
fuse secretions,  mercurial  salivation,  diseases  of  the  eye,  nasal 
polypus,  gonorrhoea  and  gleet,  bed  sores,  relaxation  of  uvula, 
skin  diseases,  ulcers,  etc. 

Dose.     Of  tannic  acid,  gr.  j  to  3j,  in  pill. 

Dental  Uses.  In  dental  practice  tannic  acid  is  a  valuable 
agent  for  local  use  in  the  treatment  of  such  diseases  as  mer- 
curial stomatitis,  ulceration  of  the  gums  and  mucous  membrane 
of  the  mouth,  hypertrophy  of  the  gums,  hemorrhage  following 
the  extraction  of  teeth  and  wounds  of  mucous  membrane, 
fungous  growth  of  pulp,  sensitive  dentine,  sponginess  of  the 
gums,  for  the  temporary  relief  of  odontalgia,  disease  of  the 
antrum.  In  mercurial  salivation  tannic  acid  in  the  form  of 
powder,  moistened  with  water,  will  render  the  spongy  gums 
firmer  and  more  comfortable,  causing  contraction  of  the  vessels 
and  checking  a  tendency  to  absorption  and  the  consequent 
loosening  of  the  teeth.  A  strong  solution  of  tannin  in  alcohol 
is  beneficial  in  obtunding  the  sensitiveness  of  dentine,  or  the 
tannin  may  be,  in  the  form  of  a  powder,  combined  with  mor- 
phia and  creasote.  Tannic  acid  in  the  form  of  a  paste  or 
ointment,  made  by  rubbing  two  scruples  of  tannin  with  twenty 
drops  of  glycerine,  and  then  with  an  ounce  of  lard,  makes  a 
good  astringent  application.  A  gargle,  composed  of  tannic 
acid  and  glycerine,  is  a  useful  application  for  abrasions  caused 
by  artificial  teeth  and  other  irritants.  A  preparation  known 
as  Elixir  of  Vitriol  and  Tannin,  saturated  solution,  is  a  power- 
ful astringent  and  haemostatic  when  applied  to  bleeding  sur- 
faces, fungous  growths,  etc. 

An  English  preparation,  known  as  Styptic  Colloid,  is  a  satu- 
rated solution  of  tannin  and  gun  cotton,  and  is  highly  recom- 
mended for  its  styptic  and  deodorizing  properties,  as  it 
solidifies   blood   and   albumen  by  mere   contact,  and  can  be 


126  DENTAL   MEDICINE. 


applied  directly  by  means  of  a  camel-hair  brush,  or,  mixed 
with  an  equal  quantity  of  ether,  in  the  form  of  spray.  No 
irritation  follows  its  use,  and  for  hemorrhage  from  the  extrac- 
tion of  teeth,  or  in  the  treatment  of  necrosed  or  carious  max- 
illary bones,  it  is  very  efficient.  Cold  or  warm  water  will  not 
dissolve  it,  but  an  ether  and  alcohol  solution  may  be  used  to 
remove  the  dressing. 

A  styptic  and  antiseptic  cotton  can  be  prepared  by  saturating 
purified  cotton  with  tannic  acid,  5  parts  ;  carbolic  acid,  4  parts ; 
alcohol,  50  parts.  The  cotton  should  be  dried  and  preserved 
air-tight. 

Glycerite  of  Tannic  h.z\A—GlyceritHm  Acidi  Tannici,  for  ex- 
ternal use,  is  made  of  Tannin,  Sij  ;  Glycerine,  Sviij. 

Ointment  of  Tannic  Acid — Unguentum  Acidi  Tannici,  is 
made  of  Tannin,  3j ;  Lard,  oj-  Useful  for  a  local  application 
to  ulcers. 

DENTAL  FORMUL/E. 

For  Odontalgia.  For  Inflamed  Mucous  Membra7ie,Abra- 

Druitt.  sions,  Ulcers  and  Sensitive  Dentine. 

R.    Acidi  Tannici gr.  xx  R.    Acidi  Tannici ^ij 

Gum  Mastich gr.  x  Tincture  Arnicse gij 

Spt.  ^ther  Sulph fgss.            M.  Tincturse  Myrrhse §j.           M. 

SiGNA. — To  be  applied  to  carious  cavity,  Signa. — To  be  used  as  a  lotion, 
on  a  pellet  of  cotton. 

For  Same  as  Above. 

For   Inflamed  and   Ulcerated  Mucous  R .    Acidi  Tannici ^:^j  to  jij 

Membrane.  Spiriti  Rectificati ^j 

R.    AcidiTannici ^ss  Aquas  Destillatse ^x.          M. 

Spiriti  Vini  Rectificati..  'Z,  ss  SiGNA. — To  be  used  as  a  gargle. 

Aquse  Camphorse f^'^-  M. 

SiGNA. — To  be  used  as  a  gargle.  For  Same  as  Above. 

R.    AcidiTannici ■••••9  ^ 

For  InflatTted  and  Ulcerated  Gums.  Pulveris   Aluminis gr.  xxx 

R.    AcidiTannici ^iv  Aquae  Destillatas ^v.          M. 

Glycerini .^ij.           M.  Signa. — To  be  used  as  a  gargle. 

SiGNA. — To   be   used   as   a  gargle   or 

mouth- wash.  For  an  Astringent  Dentifrice. 


R.    Acidi  Tannici gr.  xxx 

Cretse  Preparatse f,  ij 

Pulveris  Ossis  Sepise...  3  ij 

Olei  Caryophylli gtt.  iij.     M. 


ACIDUM    TARTARICTJM — TARTARIC    ACID.  127 

For  an  Astringent  Mouth-  Wask  in  In-         For  Chronic  Ulcers  and  Abscesses. 
Jlavied  and  Ulcerative  Conditions  of  Beral. 

Gum  and  Mucous  Membrane.  R.    Acidi  Tannici gr.  xxxij 

R.    Acidi  Tannici gr-  xx  AquEe  Destillatae f^viij.     M. 

Tincture  Pyrethri ^iij  Signa. — To  be  used  as  a  lotion. 

Aquae  RosEE ^vj.        M. 

Signa. — To  be  used  as  a  gargle.  For  Ulcerations  and  Abrasions. 

R.    Acidi  Tannici gr.  xv 

For    Injlamed  Mucous   Membrane    of  Glycerini f 5J-  ^• 

Mouth  and  Fauces.  SiGNA. — To  be  used  as  a  lotion. 

R.    Acidi  Tannici ^j 

Tincturge  Myrrhse ^iij  For  Alveolar  Hemorrhage. 

Pulv.  Acacise jij  R.    Acidi  Tannici gr.  xl 

Glycerini ^ij  Liq.  Plumb.  Subacet. 

Aq.  Destil.  q.s.  ad ^vj.         M.  Dilut f  5  iss 

Signa. — Use  as  a  gargle.  Vin.  Opii f^^s  M. 

Signa. — Apply  on  cotton  or  lint,  or  as 
an  injection. 
For  Inflamed  Mucous  Met7ibrane  of  Mouth. 

R.    Acidi  Tannici ^ss 

Sodii  Boratis ^iij 

Glycerini ^ij 

Aquce  Destillatse ^  iv.         M. 

Signa. — Use  as  a  gargle. 

ACIDUM  TARTARICUM— TARTARIC  ACID. 

Formula.     H2C4H4O6. 

Derivation.  Tartaric  acid  is  obtained  from  "  tartar  "  (a  pecu- 
liar substance  which  concretes  on  the  inside  of  wine  casks, 
being  deposited  during  the  process  of  fermentation),  or  from 
crude  cream  of  tartar. 

It  is  in  the  form  of  white  or  colorless  crystals,  irregular  six- 
sided  prisms,  and  is  soluble  in  water  and  alcohol,  and  wholly 
dissipated  by  heat. 

Medical  Properties  and  Action.  It  is  refrigerant,  and  dissolved 
in  water  and  sweetened,  is  a  good  substitute  for  lemonade. 

In  large  doses  it  is  an  irritant  poison,  and  when  its  internal 
use  is  followed  by  a  red  and  dry  tongue,  it  should  be  discon- 
tinued. It  is  often  administered  in  the  form  of  effervescing 
powders. 

Therapeutic  Uses.  Internally  it  is  employed  as  a  refrigerant, 
in  inflammatory  and  febrile  diseases,  irritability  of  the  stomach, 


128  DENTAL    MEDICINE. 


nausea  and  vomiting,  dyspepsia,  and  diseases  attended  with 
copious  secretion  of  mucus,  dysentery,  etc.,  etc. 

Dose.  Of  tartaric  acid,  gr.  x  to  gr.  xx,  dissolved  in  water 
and  sweetened. 

Dental  Uses.  In  combination  with  an  equal  quantity  of 
chloride  of  lime,  it  is  employed  for  bleaching  discolored  teeth. 

ACONITUM— ACONITE. 
Wolfsbane,  Monkhood. 

Source.  Aconite  is  obtained  from  the  dried,  tuberous  root  of 
Aconitum  Napelbis,  a  perennial  plant  abounding  in  the  moun- 
tains of  Europe  and  Asia.  .The  leaves  and  root  are  both  used, 
but  the  latter  is  the  most  powerful.  The  alkaloid  Aconitia,  a 
sedative  poison,  too  powerful  for  internal  use,  is  obtained  from 
the  root,  and  is  externally  employed  for  neuralgic  affections, 
producing  a  sensation  of  heat  and  pricking,  succeeded  by  a 
feeling  of  numbness  and  constriction  in  the  part  on  which  it  is 
rubbed. 

Medical  Properties  a7id  Action.  Aconite  is  a  powerful  seda- 
tive to  the  nervous  system,  and  reduces  the  force  of  the 
circulation.  In  large  doses  it  is  an  active  poison,  lessening 
the  heart's  action,  affecting  its  ganglia  and  muscle,  and  para- 
lyzing the  muscles  of  respiration.  In  moderate  doses  it 
produces  warmth  in  the  stomach,  general  warmth  of  the  body, 
and  sometimes  nausea,  numbness  and  tingling  in  the  lips  and 
fingers,  muscular  weakness,  diminished  force  and  frequency  of 
the  pulse,  and  diminished  respiration.  It  proves  fatal,  in  poison- 
ous doses,  by  its  powerfully  sedative  impression  on  the  nervous 
system,  by  suspension  of  the  respiratory  function,  and  by 
syncope. 

Therapeutic  Uses.  Aconite,  in  the  form  of  an  extract  pre- 
pared from  the  leaves,  and  a  tincture  prepared  from  the  root, 
is  administered  in  all  inflammatory  and  febrile  affections,  acute 
rheumatism,  neuralgia,  especially  in  chronic  cases  of  neuralgia, 
where  all  the  signs  of  active  disease  are  absent,  or  have  been 
relieved  by  other  remedies ;  tetanus,  sciatica,  diseases  of  the 
heart,  erysipelas,  amenorrhoea,  tonsillitis,  acute  congestion  of 


ACONITUM ACONITE.  129 


liver,  peritonitis,  eruptive  fevers,  etc.,  etc.  It  is  contra-indicated 
in  inflammatory  conditions  of  the  gastro-intestinal  mucous 
membrane.  It  is  locally  applied  to  painful  sprains  and  bruises, 
and  chronic  arthritic  swellings. 

Dose.  Of  the  tincture  of  Aconite — Tinctura  Aconiti — gtt. 
j  to  gtt.  v ;  of  the  Extract  of  Aconite — Extractum  Aco7iiti — 
gr.  j  to  gr.  ij.  The  tincture  of  the  root  is  composed  of  twelve 
troy-ounces  to  alcohol  Oij. 

Dental  Uses.  Aconite  in  the  form  of  the  tincture  is  a  valuable 
agent  in  dental  practice.  When  locally  applied  it  subdues  in- 
flammation in  its  early  stages,  by  paralyzing  the  nerves  of  the 
part  and  lessening  the  incitement  to  the  local  afflux  of  blood, 
favoring  resolution  and  limiting  the  extent  of  an  abscess  where 
pus  is  already  formed.  Combined  with  an  equal  part  of  the 
tincture  of  iodine,  it  is  a  valuable  application  in  the  incipient 
stages  of  dental  periostitis.  For  such  a  purpose  the  gum  over 
the  root  of  the  affected  tooth  should  be  painted  with  this  combi- 
nation until  it  assumes  a  dark  brown  color,  taking  the  precau- 
tion to  first  remove  all  moisture  from  the  surface  to  which  it  is 
to  be  applied,  and  after  its  application,  protecting  the  adjoining 
parts,  such  as  the  lips  or  cheeks,  until  the  remedy  is  absorbed. 
A  drop  or  two  of  the  tincture  introduced  into  the  cavity  of  an 
aching  tooth  will  relieve  odontalgia ;  and  the  same  quantity 
will  subdue  the  pain  which  follows  the  extraction  of  a  tooth, 
especially  when  the  cause  has  been  the  inflammation  of  the 
dental  periosteum.  Tincture  of  aconite  is  also  serviceable  in 
the  conservative  treatment  of  irritated  or  inflamed  pulps  of 
teeth.  Combined  with  an  equal  quantity  of  chloroform,  it  is 
applied  as  a  local  anaesthetic  for  the  extraction  of  teeth.  For 
the  same  purpose  it  is  combined  with  chloral,  pyrethrum, 
morphia,  etc.  (See  Dental  Formula.)  It  is  also  a  useful 
dressing  for  the  pulp  canals  of  teeth,  preventing  the  formation 
of  inflammatory  products.  The  alkaloid,  aconitia,  is  a  useful 
remedy  in  neuralgia  of  the  fifth  pair  of  nerves.  (See  Dental 
Formula.)  Care  is  necessary  in  the  application  of  the  tinc- 
ture of  aconite  to  large  surfaces,  or  where  the  skin  is  abraded, 
as  dangerous  constitutional  effects  may  result.     Fifteen  drops 


130 


DENTAL    MEDICINE. 


of  the  tincture  taken  internally  have  caused  death.  The 
symptoms  of  poisoning  by  aconite  are  as  follows :  Over- 
powering sense  of  fatigue  in  the  lower  extremities,  great 
muscular  weakness,  dimness  of  vision,  with  dilated  pupils ; 
great  dyspnoea,  the  respirations  being  short  and  labored ;  the 
pulse  at  first  slow  and  small,  and  afterward  imperceptible  ; 
surface  of  body,  tongue  and  breath  cold  ;  a  profuse  perspiration; 
muscles  of  respiration  paralyzed ;  ceasing  of  the  heart's  action. 
The  antidotes  are  heat,  brandy  and  ammoniae. 

DENTAL  FORMULAE. 


A  Local  Ancesthetic  for  the  Extraction 
of  Teeth,  etc. 

R.     Tincturse  Aconiti ,^  iss 

Py  rethri ^!^  iij 

Veratrinae gr.  x 

Morphinje  Sulphas gr.  iv 

Spiriti  Rectificati ^^  iv 

Chloral  Hydratis gr.  iv.     M. 

Let  stand  4  days  and  then  filter. 
SiGNA. — Apply  to  the  gum  over  root  of 
tooth  to  be  removed,  for  60  seconds, 
by  means  of  an  applicator. 

For  Neuralgia. 
R .     Linimenti  Aconiti. 

Lin.  Belladonnas. ..aa...  ^^ij 

Chloroformi r^ij-        M. 

SiGNA. — Apply,  on  lint,  to  the  part  af- 
fected, and  cover  with  a  fine  piece  of 
sponge  saturated  with  warm  water. 

For  Neuralgia  and  Rheumatic  Pains, 
Bruises,  etc. 

R .     Tincturse  Aconiti. 

Chloroformi  Venalis, 
Spiriti  Ammoniae. ..aa..f  3  ij 

Olei  Ricini ^ij 

Linimenti  Saponis f^j.         M. 

SiGNA. — To  be  rubbed  on  affected  part. 


For  Neuralgia. 
R.     Pulveris  Radicis  Aconiti  ^x 

Camphorae ^  ss 

Spiriti  Rectificati q.  s. 

Moisten  the  aconite  with  some  of  the 
alcohol  and  macerate  in  a  close  ves- 
sel for  3  days,  then  percolate  slowly 
into  a  receiver  containing  the  cam- 
phor until  the  product  measures  y^- 
pint. 
SiGNA. — Apply  with  a  camel-hairbrush. 

For  Neuralgia  of  Fifth  Pair  of  Nerves. 
(For  Internal  Use.) 

R.     Aconitinas gr.  J^ 

Glycerini. 

Alcohol aa 5J 

Aquae  Menthae  Pip ^^  ij.      M. 

Dose. — A  teaspoonful. 

For  Dental  Periostitis. 
R .     Tincturse  lodi. 

Tincturae  Aconiti... aa...^  ss.    M. 
SiGNA. — Apply  to  gum  over  root  of  af- 
fected tooth  with  a  camel-hair  brush. 

For  Odontalgia. 
R .    Tincturse  Aconiti 

Chloroformi aa f^iij 

Tinct.  Capsici f^j 

Tinct.  Pyrethri. 

01.  Caryophylli...aa...f^ss 

Gum  Camph ^ss.         M. 

SiGNA. — To  be  applied  on  a  pellet  of 
cotton. 


^THER ETHER.  131 


iETHER— ETHER. 

^THER    SULPHURICUS SuLPHURIC    EtIIER. 

Foruinla.  C4H10O.  Sp.  gr. — Of  pure  ether,  O.713;  of 
stronger  ether,  0.728  ;  of  ordinary  officinal  ether,  0.750. 

Derivation.  Sulphuric  ether  is  obtained  by  the  distillation 
of  alcohol  and  sulphuric  acid,  and  is  rectified  by  re-distillation 
with  solution  of  potassa.  The  form  of  sulphuric  ether  em- 
ployed for  inhalation  is  still  further  purified  by  agitation  with 
water,  and  it  is  freed  from  this  and  from  an  excess  of  alcohol 
and  deleterious  acid  substances  by  the  action  of  chloride  of 
lime  and  freshly  calcined  lime,  when  it  is  known  as  stronger 
ether — ^tJier  Fortior.  Sp.  gr.  0.728.  Sulphuric  ether  is  a 
colorless,  limpid,  volatile  and  inflammable  fluid,  with  a  sweet 
odor  and  a  hot,  pungent  taste ;  on  account  of  its  great 
volatility,  it  should  be  kept  securely  in  ground-glass-stoppered 
bottles.  It  usually  reddens  litmus  paper  slightly;  when  it  does 
so  strongly,  the  ether  is  impure.  The  impurities,  besides  acids 
and  fixed  substances,  are  heavy  oil  of  wine,  an  excess  of  alco- 
hol and  water.  Acids  being  detected  by  litmus  paper,  may  be 
removed  by  agitation  with  potassa ;  fixed  substances  may  be 
removed  by  evaporating  the  ether.  Some  alcohol  is  always 
found  in  ether,  and  it  is  only  when  it  is  present  in  too  great  a 
quantity  that  the  density  of  the  ether  is  rendered  too  high. 
The  quantity  of  alcohol  any  preparation  of  ether  may  contain, 
can  be  determined  by  agitating  it  in  a  minim  measure  with 
half  its  volume  of  a  concentrated  solution  of  chloride  of  cal- 
cium. This  will  remove  the  alcohol,  and  the  reduction  of  the 
volume  of  ether  when  it  rises  to  the  surface  will  indicate  the 
amount  of  alcohol  which  has  been  present.  Heavy  oil  of  wine 
can  be  detected  by  the  ether  becoming  milky  when  mixed  with 
water.  Ether  boils  at  98°,  F.,  and  a  cold  of  166°  below  zero 
will  not  freeze  it.  When  kept  too  long  it  undergoes  decom- 
position, and  is  converted  in  part  into  acetic  acid. 

It  evaporates  so  readily  and  completely  in  the  air  as  to  cause 
a  great  degree  of  cold,  hence  it  has  been  employed  in  the  form 
of  spray,  as  a  local  anaesthetic.     It  combines  with  alcohol  and 


132  DENTAL    MEDICINE. 


chloroform  in   all  proportions,  and  dissolves  in  ten  times  its 
volume  of  water. 

Medical  Properties  and  Actions.  Ether  is  a  diffusible  stimu- 
lant, antispasmodic,  anodyne  and  anaesthetic.  It  is  administered 
internally  in  the  form  of  ether  or  of  Hoffman's  Anodyne, 
compound  spirit  of  ether — Spiritus  Etheris  Compositus  (com- 
posed of  ether,  Oss,  ethereal  oil,  fovj,  and  alcohol,  Oj);  also, 
in  the  form  of  spirit  of  nitrous  ether,  Spiritus  Etheris  Nitrosi, 
and  known  as  sweet  spirit  of  nitre  (a  solution  of  nitrous  ether 
in  alcohol). 

When  ether  is  taken  into  the  stomach,  it  causes  a  cooling 
sensation,  after  the  subsidence  of  the  burning,  which  is  quickly 
diffused  over  the  body,  increased  action  of  the  heart,  flushing 
of  face  and  warmth  of  surface  follow  in  a  few  minutes ;  the 
senses  are  quickly  excited;  the  mind  becomes  more  active,  and 
the  phenomena  of  alcoholic  intoxication  result,  which  soon 
pass  away,  leaving  a  feeling  of  calmness  and  sleep. 

Therapeutic  Uses.  Ether  is  employed  internally  as  an  anti- 
spasmodic and  anodyne,  for  angina  pectoris,  hysteria,  asthma, 
flatulence,  cramp  of  stomach  and  bowels,  syncope,  epilepsy, 
hiccough,  nervous  or  hysterical  headache.  Hoffman's  Ano- 
dyne possesses  the  antispasmodic  and  stimulating  effects  of 
ether,  and  the  anodyne  effects  of  ethereal  oil,  or  oil  of  wine, 
and  is  also  carminative. 

Tlie  Spirit  of  Nitrous  Ether  is  antispasmodic,  diaphoretic,  and 
diuretic,  and  is  employed  in  febrile  affections,  dropsies,  etc.,  etc. 

Dose.  Of  Ether,  f5ss  to  foj ;  of  Hoffman's  Anodyne,  f5ss 
to  5ij,  in  sweetened  water;  of  spirit  of  nitrous  ether,  foss  to  foss. 

Dental  Uses.  Ether  is  employed  as  a  general  and  local  anses- 
thetic ;  as  a  topical  anodyne  in  neuralgia  and  odontalgia,  for  which 
purpose  it  is  generally  combined  with  other  agents ;  in  aphthae  and 
stomatitis  ;  as  a  counter-irritant,  evaporation  being  prevented. 

Sulphuric  Ether  as  an  Anesthetic  Agent.  Sulphuric 
ether  is  generally  considered  to  be  a  safer  anaesthetic  agent 
than  chloroform,  as  but  comparatively  few  deaths  have  resulted 
from  its  inhalation.  The  discovery  of  its  anaesthetic  properties 
was  first  made  in    1844,   by  Dr.  Horace  Wells,  a  practicing 


^THER ETHER.  133 


dentist,  of  Hartford,  Conn. ;  and  Dr.  Morton,  of  Boston,  also 
a  dentist,  first  demonstrated  the  application  of  its  anEEsthetic 
properties  in  dentistry  and  surgery,  in  1846. 

As  the  physiological  actions  of  both  ether  and  chloroform 
are  similar,  they  may  be  considered  as  follows  :  When  the 
vapor  of  ether  or  chloroform  is  inhaled,  the  first  effect  is  faucial 
irritation,  to  a  greater  or  less  degree,  according  to  the  strength 
of  the  agent  employed,  a  feeling  of  suffocation,  with  cough,  a 
flow  of  mucus  and  the  reflex  act  of  swallowing.  The  desire 
for  air  may  cause  more  or  less  struggling,  especially  in  the 
case  of  children.  The  sensibility  of  the  glottis,  however,  is 
soon  relieved,  the  cough  ceases,  and  the  inhalation  of  the  agent 
proceeds  without  further  resistance. 

The  primary  effect  is  a  general  exhilaration ;  and,  in  the  case 
of  ether  especially,  it  is  often  one  of  excitement,  which,  in  the 
majority  of  cases,  may  continue  for  a  short  time  only,  while, 
in  other  cases,  it  may,  from  its  duration  and  violence,  give  rise 
to  considerable  trouble.  But,  if  the  inhalation  can  be  con- 
tinued and  this  stage  of  excitement  passed  over,  insensibility 
soon  occurs.  The  pulse  increases  in  frequency,  the  respira- 
tions become  more  rapid,  and  may  assume  a  convulsive  char- 
acter. There  is  flushing  of  the  face,  cerebral  intoxication,  to 
a  greater  or  less  degree,  according  to  the  temperament,  such 
as  talking,  laughing,  singing,  crying,  etc.  In  those  of  a  mer- 
curial or  hysterical  disposition  this  stage  of  excitement  is  more 
pronounced  and  persistent,  and  during  its  continuance  sensi- 
bility to  pain  is  considerably  diminished,  although  the  sense 
of  touch  is  still  preserved,  while  those  of  taste  and  smell  are 
lost,  and  complete  insensibility  soon  follows. 

When  the  patient  is  of  a  full  habit,  and  in  robust  health, 
and  the  inhalation  of  the  anaesthetic  agent  has  been  rapid,  the 
stage  of  complete  insensibility  is  preceded  by  a  convulsive 
stage,  during  which  there  is  rigidity  of  the  voluntary  muscles, 
stertorous  breathing  and  lividity  of  the  face.  If  the  inhalation 
of  the  agent  be  still  further  continued,  the  tetanic  rigidity  of 
the  muscles  subsides,  the  lividity  of  the  face  disappears,  the 
breathing  becomes  quiet,  complete  muscular  relaxation  ensues, 


134  DENTAL    MEDICINE. 


power  of  movement  is  lost,  as  shown  by  the  arm,  when  raised, 
dropping  without  resistance,  and  the  conjunctiva  of  the  eye, 
under  mechanical  irritation,  being  perfectly  insensible  to  pain. 
During  complete  ansesthesia  the  surface  of  the  face  is  cool 
and  bathed  in  abundant  perspiration ;  the  countenance  is  calm, 
the  eyes  closed  and  the  pupils  somewhat  contracted,  the  respi- 
ration easy  and  the  pulse  slower.  The  functions  of  respiration 
and  circulation  continue,  all  others  being  suspended.  From 
such  a  condition  the  patient  will  soon  emerge,  provided  the 
further  inhalation  of  the  agent  be  stopped ;  on  the  other  hand, 
if  the  inhalation  be  continued,  the  functions  of  respiration  and 
circulation  will  be  suspended,  and  life  will  end  with  the  cessa- 
tion of  the  action  of  the  heart  and  the  respiratory  organs. 
Sudden  death  from  the  inhalation  of  anaesthetic  agents  is  due 
to  paralysis  of  the  cardiac  ganglia.  When  death  occurs  during 
the  stage  of  rigidity  and  stertorous  breathing,  it  is  due  to 
tetanic  fixation  of  the  respiratory  muscles  and  obstruction  of 
the  pulmonary  circulation,  accumulation  of  venous  blood  in 
the  heart  and  the  arrest  of  the  heart's  action. 

Death  may  also  ensue  by  paralysis  of  the  respiratory  mus- 
cles during  the  stage  of  complete  muscular  relaxation ;  also 
by  paralysis  of  the  heart  during  complete  insensibility,  the 
motor  ganglia  being  paralyzed. 

Death  may  also  occur  from  depression  of  the  functions  and 
the  shock  of  the  accident,  or  of  the  surgical  operation. 

The  Administration  of  An/ESTHetics.  To  administer 
ether  or  chloroform,  take  a  folded  piece  of  lint,  of  three  or  four 
thicknesses,  and  of  a  size  that  can  be  held  conveniently  in  the 
hollow  of  the  fingers  and  palm  of  the  hand,  and  on  it  pour 
the  anaesthetic  agent — a  half  ounce  of  ether  or  a  drachm  of 
chloroform.  Some  prefer  a  large  napkin  or  towel,  folded  in 
the  form  of  a  cone,  with  an  opening  of  an  inch  or  an  inch  and 
a  half  at  the  apex,  for  the  admission  of  air.  The  advantage, 
however,  of  the  lint  over  the  folded  napkin  is,  that  by  holding 
the  lint  in  the  hand  but  little  evaporation  occurs.  Before 
commencing  the  inhalation,  the  condition  of  the  pulse  should 
be  ascertained,  by  placing  the  middle  finger  of  the  left  hand 


^THER ETHER.  135 


on  the  left  temporal  artery,  and  at  the  same  time  endeavor  to 
reassure  the  patient  and  allay  fear  by  cheerful  words.  The 
clothes  should  be  loose.  The  inhalation  should  be  commenced 
by  holding  the  moistened  lint  or  towel  three  or  four  inches 
from  the  patient's  face,  directing  him  to  breathe  quite  natu- 
rally, always  remembering  that  a  strong  atmosphere  in  the 
early  stages  of  the  inhalation  is  dangerous,  and  carefully 
watching  for  coughing  or  acts  of  swallowing,  when,  if  any 
such  occur,  the  lint  or  towel  should  be  moved  further  away, 
and  approached  again  more  gradually.  If  the  patient  shows 
no  signs  of  the  anaesthetic  vapor  being  too  strong,  the  lint  or 
towel  may  be  gradually  brought  to  within  an  inch  and  a  half 
of  the  patient's  mouth  and  nostrils  ;  and  to  still  more  concen- 
trate the  atmosphere,  if  lint  is  used,  the  hand  holding  it  may 
be  covered  with  one  fold  of  an  ordinary  large  napkin,  which 
may  hang  loose  over  the  mouth  and  chin,  but  should  be  so 
arranged  above  that  the  patient's  eyes  and  forehead  may 
remain  uncovered  and  visible.  The  inhalation  should  be  com- 
menced cautiously,  by  instructing  the  patient  to  breathe  quite 
naturally,  and  to  obey  any  direction  given  to  raise  the  hand 
or  open  the  eyes. 

When  the  inhalation  has  fairly  commenced,  it  should  be 
continued  until  there  is  no  winking  when  the  margins  of  the 
eyelids  are  touched  or  the  hand  cannot  be  raised,  and  the 
limbs  are  perfectly  relaxed,  when  the  patient  is  ready  for  the 
operation;  what  is  termed  the  "surgical  period"  having  ar- 
rived. An  inhalation  with  chloroform  generally  takes  about 
four  minutes;  often  more;  seldom  less.  With  ether,  the  time 
required  is  longer  and  the  quantity  of  the  agent  greater. 

It  should  also  be  remembered  that,  in  summer,  chloroform 
and  ether  evaporate  more  readily  than  in  the  colder  seasons. 

The  operator  should  devote  his  undivided  attention  to  the 
patient,  during  the  inhalation  of  anaesthetics.  One  finger 
should  be  kept  on  the  pulse,  and  the  respiration  should  be 
carefully  noted ;  for  the  latter  is  of  more  importance  than  the 
former,  although  the  pulse  is  by  no  means  to  be  neglected. 
When  the  patient  becomes  excited,  he  should  be  watched  very 


136  DENTAL    MEDICINE. 


closely,  and  if  the  respiration  becomes  proportionately  quick- 
ened, so  must  the  vapor  of  the  anaesthetic  be  proportionately 
weakened,  by  withdrawing  the  lint  or  towel  slightly  from  the 
face. 

When  the  muscles  become  rigid,  and  the  patient  holds  his 
breath  and  becomes  livid,  the  anaesthetic  should  be  given  very 
weak  indeed,  as  such  a  state  of  semi-asphyxiation,  due  to  the 
suspension  of  respiration,  is  often  followed  by  extreme  rapidity 
and  depth  of  respiration,  and  a  dangerous  condition  is  apt  to 
supervene,  because  anaesthesia  is  added  to  asphyxia.  The 
cumulative  action  of  these  general  anaesthetics  should  also  be 
remembered,  for  a  state  of  narcosis  frequently  intensifies  for 
half  a  minute  or  more  after  the  suspension  of  the  administra- 
tion, which  is  due  to  the  vapor  of  the  anaesthetic  which  was  in 
the  lungs  entering  the  blood  after  the  administration  ceases. 

Prof  J.  J.  Chisholm,  of  the  University  of  Maryland,  gives 
the  following  five  simple  rules  for  the  administration  of  chloro- 
form, and  which  will  apply  to  ether  also. 

1 .  "I  always,  without  a  single  exception,  give  a  strong  drink 
of  whiskey,  from  one  to  two  ounces,  to  every  adult  to  whom 
I  intend  to  administer  chloroform.  This  is  done  a  few  minutes 
before  the  operation. 

2.  Always  loose  the  neck  and  chest  clothing,  so  as  to  have 
no  impediment  to  respiration. 

3.  Only  administer  chloroform  in  the  recumbent  posture, 
with  body  perfectly  horizontal  and  head  on  a  low  pillow,  this 
pillow  to  be  removed  as  the  anaesthesia  progresses. 

4.  Give  chloroform  on  a  thin  towel,  folded  in  conical  form, 
with  open  apex,  so  that  the  vapor,  before  inhalation,  will  be 
freely  diluted  with  atmospheric  air.  In  holding  this  cone  over 
the  face  of  the  patient,  at  some  little  distance  from  the  nose, 
place  the  fingers  under  the  borders  of  the  cone,  for  the  double 
purpose  of  allowing  air  to  enter  freely,  and  also  to  prevent  the 
chloroform  liquid  on  the  towel  from  coming  in  contact  with  the 
skin  of  the  patient's  face,  and  thereby  avoid  its  blistering 
effects. 

5.  Should  loud  snoring  occur,  force  up   the   chin.     This 


^THER ETHER.  137 


manipulation,  by  straightening  the  air  passages  from  the  nose  to 
the  larynx,  makes  easy  breathing.  The  forcible  elevation  of 
the  chin  is  far  better  in  every  respect  than  pulling  out  the 
tongue.  It  is  easier  of  application,  more  quickly  done,  re- 
quires no  instruments,  and  is  much  more  efficient  in  removing 
Ihe  impediment  to  respiration. 

While  operating,  I  have  constantly  in  view  both  the  color 
of  the  face  and  the  respiration  of  the  patient,  which  I  consider 
even  more  important  for  the  surgeon  to  observe  than  to  feel  the 
pulse  " 

When  ether  or  chloroform  is  administered  for  the  extraction 
of  teeth,  the  operation  should  be  performed  in  a  dental  chair 
so  constructed  as  to  admit  of  the  patient  being  placed  in  as 
horizontal  a  position  as  is  possible,  to  operate  successfully,  and 
every  instrument  it  is  necessary  to  use  should  be  within  reach 
of  the  hand  of  the  operator.  As  soon  as  the  operation  is  com- 
pleted, the  head  of  the  patient  should  be  gently  inclined  to  the 
side,  so  as  to  permit  the  blood  to  run  from  the  mouth  and  not 
pass  down  the  throat.  Any  considerable  change  in  the  posi- 
tion of  the  patient  should  be  avoided  until  recovery  has  taken 
place.  Fresh  air  should  be  admitted  by  lowering  the  window, 
and  the  patient  freely  supplied  with  it  by  means  of  a  fan. 

The  Dangers  of  Anesthesia. — The  conditions  rendering 
general  anaesthetics  dangerous  are  fatty  degeneration  of  the 
heart  (a  prominent  contra-indication) ;  previous  alcoholic  habits ; 
brain  tumors  and  degenerations  ;  respiratory  obstruction  from 
swollen  epiglottis,  enlarged  tonsils,  oedema  glottidis,  laryngeal 
paralysis,  thoracic  tumors  or  aneurism ;  emphysema  and  ob- 
structed pulse  circulation  from  engorgement  of  right  heart 
and  deficient  heart  power ;  valvular  lesions ;  incomplete 
anaesthesia  during  painful  surgical  operations,  causing  death 
from  shock,  as  the  result  of  peripheral  irritation.  Muscular 
debility  and  weakness  from  exhaustion,  if  otherwise  uncompli- 
cated, are  considered  to  be  rather  aids  to  anaesthesia  than  con- 
tra-indications. 

Preventive  Measures  Against  the  Dangers  of  Anes- 
thesia.— A   thorough    examination    for    sources    of    danger 
lo 


138  DENTAL   MEDICINE. 


should  always  be  made  previous  to  the  administration  of  the 
anaesthetic.  An  anaesthetic  should  never  be  administered  on 
a  full  stomach,  as  an  anaesthesia  of  the  glottis  prevents  the  ex- 
pulsion of  vomited  matter  from  the  larynx,  in  case  it  enters  by 
regurgitation.  An  anaesthetic  should  never  be  administered 
after  long  fasting,  as  absence  of  nutrition  may  tend  toward 
cardiac  paralysis.  One  or  two  ounces  of  whiskey  should  be 
administered  immediately  before  the  operation.  All  excite- 
ment should  be  avoided  to  the  patient  from  fear,  sight  of  in- 
struments, too  many  spectators,  etc.,  all  of  which  tend  to  induce 
shock.  All  appliances  for  resuscitation  should  be  at  hand,  and 
plenty  of  fresh  air  be  available  during  the  inhalation.  In  using 
chloroform  mix  only  three  and  a  half  per  cent,  of  the  vapor 
with  air,  to  ensure  safety.  In  the  administration  of  ether  the 
respirations,  according  to  some  authorities,  alone  need  be 
watched  ;  in  chloroform,  however,  both  the  respirations  and  the 
pulse  should  be  carefully  noted. 

Treatment  of  Dangerous  Symptoms  of  Anesthesia. — 
The  suspension  of  the  heart's  action  necessitates  the  immediate 
withdrawal  of  the  vapor  and  the  immediate  inversion  of  the 
patient,  according  to  Nelaton's  method.  The  failure  of  respi- 
ration necessitates  the  forcible  drawing  out  of  the  tongue  to 
lift  the  epiglottis ;  the  practice  of  artificial  respiration  by  the 
Sylvester  method,  and  by  faradization  of  the  respiratory  mus- 
cles; the  inhalation  of  gtt.  iij  to  gtt.v  of  nitrite  ofamyl;  ammonia 
to  the  nostrils ;  galvanism  (the  positive  pole  being  placed  to 
the  nostril,  and  the  negative  pole  over  the  diaphragm,  to  excite 
a  reflex  action  between  the  fifth  pair  and  the  pneumogastric,  or 
the  poles  may  be  placed  directly  over  both  phrenic  nerves,  on 
a  line  with  the  fourth  cervical  vertebrae,  in  order  to  stimulate 
respirations  ;  or  one  pole  may  be  placed  over  the  upper  dorsal 
spinous  process,  and  the  other  pole  over  the  apex  of  the  heart, 
to  induce  cardiac  contraction).  Artificial  warmth  should  be 
applied,  but  no  cold  applications. 

The  inversion  of  ths  body,  according  to  Nelaton's  method, 
and  artificial  respiration,  according  to  Sylvester's  method,  and 
Marshall   Hall's   ready  method,  are  safe,  and   are  the  most 


TETHER ETHER.  139 


promising  expedients.    A  simple  method  of  producing  artificial 
respiration  is  as  follows  : — 

"  With  outspread  palms,  press  the  front  of  the  chest  forcibly- 
down,  whilst  an  assistant  at  the  same  time  presses  the  abdo- 
men. Make  these  movements  not  oftener  than  fifteen  times  in 
the  minute." 

DR.  H.  R.  SYLVESTER'S  METHOD  OF  RESUSCITATION. 

"  To  Adjust  the  Patient's  Position.  Place  the  patient  on  his 
back,  on  a  flat  surface ;  raise  and  support  the  head  and  shoul- 
ders on  a  small,  firm  cushion,  or  folded  article  of  dress,  placed 
under  the  shoulder-blades  ;  remove  all  tight  clothing  about  the 
neck  and  chest. 

"  To  Maintain  a  Free  Entrance  of  Air  i?ito  the  Windpipe. 
Cleanse  the  mouth  and  nostrils ;  open  the  mouth ;  draw  for- 
ward the  patient's  tongue,  and  keep  it  forward ;  an  elastic  band 
over  the  tongue  and  under  the  chin  will  answer  this  purpose. 

"  To  Imitate  the  Movemejits  of  Breathing : — 

"First,  Induce  Inspiration.  Place  yourself  at  the  head  of  the 
patient ;  grasp  his  arms ;  raise  them  upward  by  the  sides  of 
his  head ;  stretch  them  steadily,  but  gently,  upward  and  back- 
ward, for  two  seconds.  By  this  means  fresh  air  is  drawn  into 
the  lungs,  by  raising  the  ribs. 


"  Secondly,  Induce  Expiration.  Immediately  turn  down  the 
patient's  arms,  and  press  them  firmly,  but  gently,  downward 
against  the  sides  of  his  chest,  for  two  seconds.  By  this  means 
foul  air  is  expelled  from  the  lungs,  by  depressing  the  ribs. 


140  DENTAL    MEDICINE. 


"  Thirdly,  Continue  these  Movements.  Repeat  these  move- 
ments alternately,  deliberately  and  perseveringly,  fifteen  times 
in  a  minute,  until  a  spontaneous  effort  to  respire  be  perceived. 


By  these  means  an  exchange  of  air  is  produced  in  the  lungs, 
similar  to  that  effected  by  natural  respiration." 

MARSHALL  HALL'S  READY  METHOD  IN  ASPHYXIA. 

"  I  St.  Treat  the  patient  instantly^  on  the  spot,  in  the  open  air, 
freely  exposing  the  face,  neck  and  chest  to  the  breeze,  except 
in  severe  weather. 

"  2d.  In  order  to  clear  the  throat,  place  the  patient  gently  on 
the  face,  with  one  wrist  under  the  forehead,  that  all  fluid,  and 
the  tongue  itself,  may  fall  forward,  and  leave  the  entrance  into 
the  windpipe  free. 

"  3d.  To  excite  respiration,  turn  the  patient  slightly  on  his  side, 
and  apply  some  irritating  or  stimulating  agent  to  the  nostrils, 
as  Veratriiie,  dilute  Ammonia,  etc. 

"4th.  Make  the  face  warm  by  brisk  friction;  then  dash  cold 
water  upon  it. 

"5th.  If  not  successful,  lose  no  time;  but,  to  imitate  respira- 
tion, place  the  patient  on  his  face,  and  turn  the  body  gently, 
but  completely,  on  the  side  and  a  little  beyond;  then  again  on 
the  face,  and  so  on,  alternately.  Repeat  these  movements 
deliberately  and  perseveringly,  fifteen  times  only  in  a  minute. 
(When  the  patient  lies  on  the  thorax,  this  cavity  is  compressed 
by  the  weight  of  the  body,  and  ^jrpiration  takes  place.  When 
he  is  turned  on  the  side,  this  pressure  is  removed,  and  zV/spira- 
tion  occurs.) 

"6th.  When  the  prone  position  is  resumed,  make  a  uniform 
and  efficient  pressure  along  the  spine,  removing  the  pressure 


/ETHER ETHER,  141 


immediately  before  rotation  on  the  side.  (The  pressure 
augments  the  ^vrpiration ;  the  rotation  commences  zV^spiration.) 
Continue  these  measures. 

"  7th.  Rub  the  limbs  upward,  with  firm  pressure  and  with 
energy.  (The  object  being  to  aid  the  return  of  venous  blood 
to  the  heart.) 

"8th.  Substitute  for  the  patient's  wet  clothing,  if  possible, 
such  other  covering  as  can  be  instantly  procured,  each  by- 
stander supplying  a  coat  or  cloak,  etc.  Meantime,  and  from 
time  to  time,  to  excite  inspiration,  let  the  surface  of  the  body 
be  slapped  briskly  with  the  hand. 

"9th.  Rub  the  body  briskly  till  it  is  dry  and  warm,  then 
dash  cold  water  upon  it,  and  repeat  the  rubbing. 

"  Avoid  the  immediate  removal  of  the  patient,  as  it  involves 
2.  dangerous  loss  of  time  ;  also  the  use  of  bellows,  or  any /(jraV^^ 
instrument;  also,  the  warm  bath,  and  all  rough  treatment" 

Local  Anesthesia.  The  fatality  attending  the  use  of 
general  anaesthetics  led  to  the  introduction  of  what  are  termed 
"  local  anaesthetics,"  the  most  important  of  which  depend  upon 
the  therapeutic  property  of  cold,  which  is  properly  an  anaes- 
thetic only  when  it  freezes  the  part  to  which  it  is  applied.  The 
use  of  cold  for  such  a  purpose  must  necessarily  be  limited  to 
small  parts  of  the  body,  and  its  utility  depends  upon  the  ease 
and  rapidity  with  which  a  desired  spot  of  living  flesh  can  be 
frozen ;  in  other  words,  temporarily  deprived  of  its  vitality, 
without  inflicting  mechanical  injury  on  the  delicate  structure 
of  the  part. 

According  to  Dr.  Richardson,  the  proposer  of  the  method, 
the  principle  consists  in  directing  on  a  part  of  the  body  a 
volatile  liquid,  having  a  boiling  point  at  or  below  blood  heat, 
in  a  state  of  fine  subdivision  or  spray,  such  subdivision  being 
produced  by  the  action  of  air  or  other  gaseous  substance  on 
the  volatile  liquid  to  be  dispersed.  When  it  falls  on  a  part  of 
the  body,  it  comes  with  force  into  the  most  minute  contact 
with  the  surface  upon  which  it  strikes. 

As  a  result,  there  is  rapid  evaporation  of  the  volatile  fluid, 
and  so  g-reat  an  evolution  of  heat  force  from  the  surface  of  the 


142  DENTAL    MEDICINE. 


part  to  which  the  spray  is  appHed,  that  the  blood  cannot  supply 
the  equivalent  loss.  The  part  consequently  dies  for  the  moment, 
and  is  insensible ;  but  as  the  power  of  the  body  is  unaffected, 
the  blood,  as  soon  as  the  external  reducing  agency  is  withdrawn, 
quickly  makes  its  way  again  through  the  dead  parts,  and  resto- 
ration rapidly  occurs. 

The  fluids  used  are  ether,  of  a  specific  gravity  not  exceeding 
0.723,  rhigolene,  a  product  of  petroleum,  and  the  lightest  liquid 
known,  and  bromide  of  ethyl. 

When  a  current  of  the  volatile  liquid,  either  atomized  ether 
or  rhigolene,  comes  in  contact  with  the  skin,  by  the  use  of  the 
spray  apparatus,  an  intense  degree  of  cold  is  produced,  which 
deprives  the  nerves  of  the  part  of  their  power  to  transmit 
impressions  to  the  sensorium.  For  the  extraction  of  teeth, 
destruction  of  the  pulps  of  teeth,  opening  abscesses,  and  other 
minor  surgical  operations,  and  neuralgia  of  superficial  nerves, 
success  has  attended  the  use  of  such  local  anaesthetics.  The 
greatest  objections  to  such  a  method  of  inducing  local  anaes- 
thesia are  the  great  pain  which  attends  the  first  application, 
and  the  unpleasant  burning  sensation  of  the  part  when  it  is 
recovering  from  the  freezing  process.  (See  Rhigolene.)  (See 
Aconite,  for  obtunding  mixture.) 

Electro-magnetism  has  also  been  employed  as  a  local  anaes- 
thetic, and  it  is  a  mooted  question  whether  it  relieves  pain  or 
complicates  the  sensations.  It  is  well,  however  to  remember, 
that  some  persons  are  so  peculiarly  constituted  as  to  render 
them  very  susceptible  to  the  influence  of  electricity.  (See 
Electricity  as  a  Therapeutic  Means,  etc.). 

ALCOHOL— ALCOHOL. 

Formula.  C2H5HO.  Sp.  gr.  of  officinal  alcohol,  0.835  ;  of 
rectified  spirit — Spiritus  Rectificatus,  0.838 ;  of  stronger  alcohol, 
— Alcohol  Fortius,  0.^17  ;  of  diluted  alcohol — Alcohol  Dilutwn 
(equal  parts  of  alcohol  and  distilled  water),  0.941. 

Derivation.  Alcohol  is  obtained  from  vinous  or  fermented 
liquors  by  repeated  distillations,  and,  in  its  officinal  form, 
contains  about  fifteen  per  cent,  of  water.    It  is  colorless,  inflam- 


ALCOHOL ALCOHOL.  143 

mable,  wholly  vaporizable  by  heat,  and  unites  in  all  proportions 
with  water  and  ether.  It  frequently  contains  such  impurities 
as  fusil  oil  or  amylic  alcohol  (obtained  from  fermented  grain 
or  potatoes),  the  presence  of  which  can  be  detected  by  agitating 
the  alcohol  with  sulphuric  acid,  when  the  former  becomes 
colored. 

Stronger  Alcohol — Alcohol  Fortius — Absolute  Alcohol — is 
obtained  by  agitating  the  officinal  alcohol  with  heated  carbonate 
of  potassium. 

Medical  Properties  and  Actions.  All  the  different  forms  of 
alcohol,  including  brandy — Spiritus  Vini  Gallici  (the  spirit 
obtained  from  fermented  grapes  by  distillation,  and  containing 
48  to  56  per  cent,  by  volume,  of  absolute  alcohol);  whiskey — 
Spiritus  Frunienti  (the  spirit  obtained  from  fermented  grain  by 
distillation,  and  containing  from  48  to  56  per  cent.,  by  volume, 
of  absolute  alcohol);  wine — Vinum  (the  fermented  juice  of  the 
grape,  and  containing  alcohol  in  varying  proportions),  are 
powerful  diffusible  stimulants,  increasing  the  action  of  the 
heart  and  arteries,  exciting  the  nervous  and  vascular  systems, 
and  causing  a  general  exhilaration  of  spirits.  Excessive  quan- 
tities produce  the  effects  of  narcotic  poisons,  ending  in  coma 
and  death. 

The  habitual  use  of  alcoholic  drinks  causes  most  injurious 
effects  upon  the  system  generally,  and  directly  upon  the  mucous 
coats  of  the  stomach,  deranging  and  destroying  its  functions 
and  structure,  resulting  in  dyspepsia,  followed  by  cirrhosis  of 
the  liver  and  kidneys,  loss  of  mental  and  physical  strength, 
derangement  of  the  nervous  system,  and,  at  last,  delirium 
tremens.  When  properly  administered  in  diseased  conditions, 
however,  alcoholic  preparations  are  valuable  agents. 

Therapeutic  Uses.  The  different  forms  of  alcohol  are  em- 
ployed as  stimulants  in  acute  inflammations,  such  as  pneumonia, 
pleurisy,  bronchitis,  pulmonary  affections  of  children,  etc.,  etc., 
and  in  rheumatic  pericarditis,  in  the  latter  stages  of  typhus 
and  typhoid  fevers,  diphtheria,  acute  neuralgia,  convulsions  of 
dentition,   tetanus,    asphyxia    from    cold,   pyaemia,    etc.,    etc. 


144  DENTAL    MEDICINE. 


Externally  in  superficial  inflammation,  bruises,  sprains,  ptyal- 
ism,  gout,  cerebral  affections,  bed  sores,  etc.,  etc. 

Dental  Uses.  Alcohol,  as  a  narcotic,  is  employed  to  relieve 
pain.  In  combination  with  tannic  acid  or  chloride  of  zinc,  it 
obtunds  the  sensibility  of  dentine ;  as  a  styptic,  it  arrests  hem- 
orrhage from  relaxed  tissues,  coagulating  the  blood  by  its 
effect  on  albumen,  and  causing  contraction  of  the  mouths  of 
the  vessels  by  its  astringent  property.  Equal  parts  of  alcohol 
and  water  make  an  excellent  application  as  an  evaporating 
lotion,  for  the  relief  of  superficial  inflammations.  For  suppu- 
rating wounds,  it  is  a  useful  antiseptic  dressing,  as  it  destroys 
germs,  removes  fetor,  and  stimulates  the  tissues  to  a  more 
healthy  action.  It  also  favors  the  cicatrization  of  open  wounds, 
coagulating  the  albumen,  and  forming  an  impermeable  covering. 
In  mercurial  salivation  (mercurial  stomatitis),  it  forms  an  excel- 
lent gargle. 

For  softened  and  sensitive  dentine,  and  for  drying  cavities 
preparatory  to  filling  them,  the  stronger  or  absolute  alcohol  is 
employed.  A  simple  method  of  preparing  this  form  of  alco- 
hol is  to  add  one  part  of  carbonate  of  potassa  to  four  parts  of 
the  ordinary  or  officinal  alcohol.  Owing  to  the  great  affinity 
carbonate  of  potassa  has  for  water,  it  abstracts  the  latter  from 
the  alcohol  to  a  sufficient  degree  to  answer  all  practical  purposes. 

The  cavity  of  a  tooth  is  first  dried  with  cotton  and  bibulous 
paper,  and  then  bathed  with  the  absolute  alcohol,  which  at 
once  evaporates,  and  causes  the  almost  perfect  absorption  of 
moisture. 

Brandy  and  water  form,  in  combination,  an  excellent  lotion 
for  mercurial  and  other  forms  of  stomatitis. 

DENTAL  FORMULA. 

For  Obtunding  Sensitive  Dentine.  For  Obtunding  Sensitive  Dentine. 

R.     Alcohol  (Absolute) ^ss  R.     Alcohol  (Absolute) 5SS 

Acidi  Tannic! ^ss  Zinci  Chloridi ^ss 

Glycerini ^ss.      M.  Glycerin!  ^ss.      M. 

For  Superficial  Inflammations.  For  Mercurial  Stomatitis. 

R.     Alcohol  R.     Spts.  Vini  Gallic! i  part 

Aquae aa ^ss.      M.  Aquae 4  to  6  parts.  M. 

SiGNA. — To  be  applied  as  a  lotion.  SiGNA. — To  be  used  as  a  gargle. 


ALUMEN ALUM.  145 


ALUMEN— ALUM. 

Formula.     Al(NH4)2(S04)i2H20. 

Source.  It  is  found  native  in  Italy,  in  the  neighborhood  of 
volcanoes,  and  is  the  mineral  from  which  the  metal  aluminium 
is  obtained. 

Derivation.  Alum  is  also  obtained  from  aluminous  slate, 
shale  or  schist,  from  which  it  is  obtained  by  the  process  of 
roasting  and  exposure  to  the  air. 

Alum  is  a  white,  slightly  efflorescent  salt,  which  crystallizes 
in  regular  octahedrons.  It  possesses  an  astringent,  acid,  and 
sweetish  taste.  It  is  insoluble  in  alcohol,  but  dissolves  in  from 
fourteen  to  fifteen  times  its  weight  of  cold,  and  three-fourths 
of  its  weight  in  boiling  water. 

Medical  Properties  aiid  Action.  Alum  is  astringent  and 
styptic,  and  is  employed  both  externally  and  internally.  When 
taken  internally,  it  is  absorbed  into  the  system,  and  has  been 
detected  in  the  liver,  spleen  and  urine.  Excessive  doses  cause 
vomiting,  griping,  purging,  and  inflammation  of  the  gastro- 
enteric mucous  membrane.  Powdered  alum,  in  doses  of  a 
teaspoonful,  is  an  efficient  emetic.  It  coagulates  albumen,  and 
causes  an  abundant  flow  of  saliva,  coagulating  the  albumen  of 
the  saliva  and  buccal  mucus  in  whitish,  membranous  flakes. 

Its  astringent  influence  is  chiefly  upon  mucous  surfaces. 
Applied  locally  to  relaxed  or  bleeding  parts,  it  corrugates  the 
surrounding  tissues  and  causes  contraction  of  the  capillaries, 
and,  in  this  manner,  acts  as  an  astringent. 

Therapeutic  Uses.  Alum  is  internally  administered  in  diar- 
rhoea, chronic  dysentery,  colica  pictonum,  catarrh  of  the  stom- 
ach, etc.  Externally  it  is  applied  in  ulcerated  and  relaxed  throat 
affection,  ptyalism,  gonorrhoea  and  gleet,  uterine  hemorrhage, 
morbid  growths,  haematuria,  ophthalmia,  chronic  whooping 
cough,  chronic  skin  diseases,  chilblains,  ulcers,  hospital  gan- 
grene, etc.,  etc. 

Dose.  Of  Alum,  gr.  x  to  3j  or  3ij,  in  powder,  or  solution  in 
water,  or  in  some  simple  infusion. 

Ammonia   Alum.      Sulphate    of  alumina   and   ammonia — 


146  DENTAL    MEDICINE. 


AlumincE  et  Ammonice  Sulphas,  is  prepared  by  adding  sulphate 
of  ammonia  to  a  solution  of  sulphate  of  alumina. 

Dried  Alum — Alunien  Exsiccatuvi  (alum  deprived  of  its 
water  of  crystallization  by  heat),  is  employed  externally  as  a 
mild  escharotic,  to  destroy  exuberant  granulations,  etc. 

Dental  Uses. — Alum  is  employed  in  dental  practice  as  a 
styptic  in  alveolar  hemorrhage ;  as  a  gargle  in  stomatitis, 
ulceration,  and  sponginess  of  the  gums,  morbid  or  fungous 
growth  of  gums,  dental  pulp,  etc.,  superficial  hemorrhage  from 
the  mucous  membrane  of  the  mouth,  ulcers  of  the  mouth, 
cancrum  oris,  odontalgia,  etc.,  etc.  In  congested  conditions  of 
the  mucous  membrane  of  the  mouth  and  throat,  alum  gargles 
afford  great  relief 

The  habitual  use  of  alum  as  an  ingredient  of  a  dentifrice  is 
injurious  to  the  teeth,  on  account  of  the  sulphuric  acid  it 
contains. 

Potassa  alum — Aluminii  et  Potassii  Sulphas,  the  alum  of 
commerce  (which  has  been  superseded  by  ammonia  alum), 
will  render  plaster  casts  hard,  when  they  are  boiled  in  a  strong 
solution  for  half  an  hour. 

DENTAL  FORMULA. 
For  Odontalgia.  For  Inflamed  and  Ulcerated  Mucous 

R  .     Pulveris  Aluminis ^ij  Membrane  and  Guj}ts. 

Athens  Nitrici ^^ij.     M.     R.     Pulveris  Aluminis gr.  Ixxx 

SiGNA. — To  be  applied  on  a  pellet  of  Aquae  Destillatse f§  x.     M. 

cotton.  SiGNA. — To  be  used  as  a  mild,  astrin- 

gent gargle. 
For  Ulceration  of  the  Gums  and  Mucous  For  Ulcerated  and  Spongy  Gums. 

Membrane  of  the  Mouth.  R.     Aluminis jj 

R.     Aluminis gj  Vini Oj 

Zinci  Sulphatis ^ss  Tinct.  Cinchonse ^ss 

Sodii  Borat grs.  iv  Tinct.  Myi-rhse gij 

Aquae  Rosse §  viij.    M.  Mel.  Rosae gij.       M. 

SiGNA. — To  be  applied  as  a  lotion.  SiGNA. — To  be  used  as  a  gargle. 

For  Inflammation  and  Ulceration  of  the 
Mouth  and  Throat. 

R.     Infus.  Lini  ^xv 

Tinct.  Kino ,^j 

Aluminis ^ij.       M. 

SiGNA. — To  be  used  as  a  gargle. 


ALUMIN/E  ACETAS ACETATE  OF  ALUMINA.       147 

ALUMINA  ACETAS— ACETATE  OF  ALUMINA. 

Formula.     AI2O32C4H3O3  +  4HO. 

Derivation.  The  salt,  acetate  of  alumina,  is  obtained  by 
the  direct  combination  of  hydrated  alumina  with  acetic  acid, 
or  by  reaction  between  sulphate  of  alumina  and  acetate  of  lead. 
The  solution,  when  properly  prepared,  is  a  clear  fluid,  of  a 
sharp,  sweetish,  astringent  taste,  and  a  distinct  odor  of  acetic 
acid.  When  it  is  evaporated,  there  is  deposited  light,  fragile, 
glossy  scales,  which  are  perfectly  soluble  in  water,  and  not 
readily  affected  by  the  atmosphere. 

Medical  Properties  and  Action.  It  is  disinfectant  and  anti- 
septic. In  maximum  doses  it  produces  an  unpleasant  sensation 
of  warmth  and  fullness  in  the  stomach,  and,  at  the  same  time, 
vertigo  and  confusion  of  the  senses,  which  may  continue  for 
several  hours. 

Therapeutic  Uses.  Acetate  of  alumina  is  rarely  employed 
internally,  and  only  for  zymotic  and  contagious  diseases.  It 
is  generally  used  externally,  and  is  a  very  effectual  remedy  in 
the  treatment  of  wounds,  preventing  pyaemia  in  suppurating 
wounds  and  ulcers.  It  is  also  applied  in  parasitic  skin  affections, 
as  an  injection  in  gonorrhoea,  and  for  the  destruction  of  animal- 
culae  in  putrescent  fluids.  As  a  surgical  dressing,  it  is  used 
by  keeping  the  wound  saturated  with  a  solution  of  moderate 
strength,  or  by  irrigation.  A  concentrated  solution  will  preserve 
anatomical  subjects  for  a  considerable  time. 

Dose.  Of  Acetate  of  Alumina,  gtt.  xx  to  gtt.  60  of  the 
solution. 

Dental  Uses.  Acetate  of  alumina  is  useful  in  dental  practice, 
as  an  antiseptic  and  disinfectant  in  cancrum  oris,  ulcers  of  the 
mouth,  suppurating  wounds  of  mucous  membrane,  pyorrhoea 
alveolaris,  alveolar  abscess,  etc.  A  very  weak  solution  has 
been  employed  as  a  mouth-wash  for  offensive  breath,  depending 
on  scrofulous  ulcerations,  aphthae,  caries  of  the  teeth,  or  the 
wearing  of  artificial  teeth. 


148  »  DENTAL    MEDICINE. 


LIQUOR    AMMONII    ACETATIS— SOLUTION    OF 
ACETATE  OF  AMMONIA. 

Spirit  of  Mindererus. 

Formula.     NH4C2H3O2. 

Derivation.  Spirit  of  Mindererus  is  obtained  by  saturating 
diluted  acetic  acid  with  carbonate  of  ammonia,  being-  a  solution 
of  the  acetate  of  ammonia. 

It  is  a  colorless  liquid,  with  a  saline  taste,  and  requires  to  be 
freshly  made  when  about  to  be  used. 

Medicinal  Properties  and  Action.  It  is  refrigerant,  diaphoretic, 
and  diuretic,  and  its  action  can  be  greatly  increased  by  combina- 
tion with  other  remedies.  Few  medicines  are  in  more  general 
use. 

Therapeutic  Uses.  Spirit  of  mindererus  is  employed  in  the 
treatment  of  febrile  and  inflammatory  affections,  and  exanthe- 
mata, sick  headache,  catarrh  and  influenza,  etc.,  etc.  Externally 
it  is  used  as  a  lotion  to  sprains,  bruises,  glandular  enlarge- 
ments, etc. 

Dose.     Of  Spirit  of  Mindererus,  f5j  to  fSj. 

Dental  Uses.  A  lotion  composed  of  one  part  to  ten  of  water 
is  a  serviceable  application  in  inflamed  conditions  of  mucous 
membrane.  Internally  administered  as  a  refrigerant,  it  is 
useful  in  acute  periosteal  inflammation,  inflammation  of  the 
dental  pulp — pulpitis,  etc. 

AMMONII  CARBONAS— CARBONATE  OF  AMMO- 
NIUM. 

Formula.     N4H18C3O9. 

Derivation.  Carbonate  of  Ammonium  is  a  sesquicarbonate, 
and  is  obtained  by  subliming  a  mixture  of  chloride  of  ammo- 
nium and  chalk.  It  is  in  the  form  of  white,  translucent  masses, 
with  a  pungent,  ammoniacal  odor,  and  an  acrid,  alkaline  taste. 
It  is  soluble  in  water,  and  on  exposure  to  the  air  it  becomes 
opaque  and  falls  into  powder,  losing  its  ammonia. 

Medical  Properties  and  Action.  It  is  antacid,  stimulant,  dia- 
phoretic and  expectorant,  and  is  considered  to  be  especially 


AMMONII  VALERIANAS VALERIANATE  OF  AMMONIUM.       149 

useful  in  cases  where  the  vital  powers  are  greatly  depressed. 
In  large  doses  it  causes  colic,  convulsions  and  great  disturb- 
ance of  the  nervous  system,  and,  when  long  continued,  an 
annoying  itching  of  the  scalp,  and  skin  over  the  surface  of  the 
body.  It  has  a  tendency  to  fluidify  the  blood.  Internally,  as 
a  diffusible  stimulant,  it  is  preferred  to  solution  of  ammonia. 

TJierapeutic  Uses.  It  is  internally  administered  in  diabetes, 
scrofula  with  languid  circulation,  asthma,  pneumonia,  croup, 
chorea,  diseases  of  the  skin,  puerperal  insanity,  mercurial  ere- 
thism, drunkenness,  etc.,  etc. 

Externally  it  is  employed  as  a  volatile  or  smelling  salts,  in 
syncope,  hysteria,  and  asphyxia. 

Dose.  Of  Carbonate  of  Ammonium,  gr.  v  to  gr.  x,  in  pill, 
or  in  solution  with  gum  and  sugar. 

Dental  Uses.  It  is  a  useful  internal  remedy  in  cancrum  oris, 
in  doses  of  gr.  v,  gradually  increased  to  gr.  x,  every  two  or 
three  hours,  using  strong  nitric  acid  as  a  local  application. 
It  is  also  a  very  useful  remedy  in  mercurial  erethism,  in  con- 
junction with  camphor  and  other  stimulants. 

AMMONII  VALERIANAS— VALERIANATE  OF 
AMMONIUM. 

Formula.     NH4C5H9O2. 

Derivation.  Valerianate  of  Ammonium  is  obtained  by  com- 
bining valerianic  acid  with  a  strong  solution  of  ammonia,  and 
evaporating  to  a  syrupy  consistence ;  it  is  also  obtained  by 
subjecting  the  monohydrated  acid  to  the  action  of  dry,  gaseous 
ammonia.  It  is  in  the  form  of  a  white  salt,  in  quadrangular 
plates,  with  the  odor  of  valerianic  acid,  and  a  sharp,  sweetish 
taste.     It  is  soluble  in  water  and  alcohol. 

Medical  Properties  and  Action.  It  is  stimulant,  nervine,  and 
antispasmodic. 

Therapeutic  Uses.  It  is  employed  in  neuralgia,  nervous  head- 
ache, hysteria,  epilepsy,  chorea,  etc.,  etc. 

Dose.  Of  Valerianate  of  Ammonium,  gr.  ij  to  gr.  viij,  in  pill, 
or  in  elixir,  with  aromatics  (valerianate  of  ammonium  5j,  fluid 
extract  of  vanilla  fSss,  tincture  of  cardamom  fovj,  curacoa. 


150  DENTAL    MEDICINE, 


f5ij,  water  fSiv — Misce.     Dose,  a  teaspoonful  three  times  a 

day). 

Dental  Uses.     It  is  internally  administered  for  neuralgia. 

AMMONII  CHLORIDUM— CHLORIDE  OF 
AMMONIUM. 

Muriate  of  Ammonia — Hydrochlorate  of  Ammonia — Sal 

Ammoniac. 

Formula.     NH4CI. 

Derivation.  Chloride  of  Ammonium  is  obtained  by  neutral- 
izing hydrochloric  acid  with  ammonia,  and  evaporating  to 
dryness.  It  is  in  the  form  of  a  snow-white,  crystalline  powder, 
soluble  in,  two  and  a  half  parts  of  cold  water,  and  sparingly 
soluble  in  alcohol.     It  has  a  pungent,  saline  taste. 

Medical  Properties  and  Action.  In  large  doses  it  is  an  irritant 
poison,  with  a  purging  action  ;  but  in  small  doses  it  is  a  power- 
ful resolvent  alterative ;  it  is  also  refrigerant  and  anodyne.  Its 
action  upon  the  system  closely  resembles  that  of  mercury  as 
an  alterative. 

Externally  it  is  used  as  a  discutient  application,  and  as  a 
cold  lotion  in  fevers,  hernia,  etc. 

Therapeutic  Uses.  It  is  employed  internally  in  amenorrhcea, 
rheumatic  affections,  chronic  bronchitis,  pneumonia,  dropsical 
affections,  hemorrhages,  whooping  cough  and  myalgia.  Exter- 
nally in  abscesses  of  the  mamma,  skin  diseases,  ecchymosis  of 
the  eye,  hydrocele,  senile  gangrene,  gonorrhoea,  leucorrhcea,  etc. 

Dose.  Of  Chloride  of  Ammonium,  gr.  v-xxx,  every  two  or 
three  hours,  in  powder  or  mucilage. 

Dental  Uses.  It  is  employed  in  facial  neuralgia,  in  doses  of 
5ss,  repeated  four  times  daily.  Externally  it  is  used  as  an 
application  to  indolent  ulcers,  for  its  stimulating  effect.  As  a 
gargle,  it  is  employed  in  the  strength  of  oSS  to  oxij  of  water. 
It  is  also  applied  to  cancerous  tumors,  and  has  been  used  to 
restore  zinc  which  has  become  deteriorated  from  long  use  in 
laboratory  work.  Chloride  of  ammonium  (sal  ammoniac)  is 
also  used  as  a  flux,  in  refining  gold  for  laboratory  use. 


AMYL    NITRIS NITRITE    OF    AMYL.  151 

AMYLENE— AMYLENE. 

Formula.     C5H10. 

Derivation.  Amylene  is  obtained  by  distilling  amylic  alcohol 
with  chloride  of  zinc.  It  is  a  colorless,  very  mobile  liquid,  with 
a  boiling  point  of  102°,  and  the  density  of  its  vapor  2.45.  It 
has  a  very  peculiar  and  disagreeable  smell. 

Medical  Properties  and  Action.  Amylene  was  introduced  as 
an  anaesthetic  in  1856,  by  the  late  Dr.  Snow,  who  regarded  it 
as  possessing  the  following  advantages  :  the  safety  of  ether, 
absence  of  pungency  and  irritating  property,  readiness  with 
which  the  absence  of  pain  is  obtained,  with  less  coma  than 
with  chloroform  or  ether,  the  speedy  recovery  from  its  effects, 
less  nauseating,  and  less  headache  and  rigidity  and  struggling 
than  in  the  case  of  ether  or  chloroform.  Others,  however,  have 
not  been  so  much  impressed  with  this  anaesthetic  agent  as  was 
Dr.  Snow ;  hence,  it  has  not  been  regarded  with  the  same  favor 
as  other  agents  of  this  class.  An  extreme  quantity  being 
required  to  produce  complete  insensibility  to  pain,  its  operation 
is  considered  to  be  dangerous. 

Therapeutic  Use.     As  an  anaesthetic. 

AMYL  NITRIS— NITRITE  OF  AMYL. 

Formida.     CgHuNOg.     Sp.  gr.  0.877. 

Derivation.  Nitrite  of  Amyl  is  obtained  by  heating  one  part 
of  strong  nitric  acid,  with  two  parts  of  rectified  fusil  oil,  until 
reaction  commences,  when  the  heat  is  withdrawn,  and  after- 
wards re-applied.  The  distilled  portion,  obtained  below  2 1 2°  F., 
is  rectified  by  means  of  carbonate  of  potassium,  and  that  portion 
only  distilling  between  202°  and  206°  F.  is  reserved,  being  a 
nitrite  of  the  oxide  of  amyl.  It  is  a  yellowish  or  amber-colored 
liquid,  somewhat  oily,  very  volatile  and  inflammable,  and  boils 
at  182°  F.     It  has  an  odor  like  that  of  ripe  pears. 

Medical  Properties  and  Action.  It  is  used  by  inhalation, 
causing  an  accelerated  action  of  the  heart,  sudden  flushing  of 
the  face,  dilatation  of  the  arteries,  a  sense  of  great  fullness  of 
the  brain,  a  lowering  of  the  blood  pressure  and  temperature. 


152  DENTAL   MEDICINE. 


and  complete  resolution  of  the  muscular  system.  The  vapor 
of  nitrite  of  amyl,  when  applied  directly  to  the  muscular  or 
nervous  tissues,  arrests  their  functional  activity,  and,  circulating 
in  the  blood,  appears  to  act  most  on  the  vaso-motor  system 
and  unstriped  muscular  fibre. 

Therapeutic  Uses.  Being  a  powerful  stimulant  to  the  heart, 
it  is  an  antidote  to  chloroform.  A  case  is  mentioned  in  the 
British  Medical  Journal,  where,  during  chloroform  narcosis, 
respiration  ceased,  and  artificial  respiration  failed  to  restore  the 
patient.  Some  nitrite  of  amyl  was  then  poured  on  lint,  and 
held  to  the  patient's  nostrils.  In  ten  seconds  there  was  a  flush- 
ing of  the  face,  the  pulse  was  again  felt,  and  respiration  was 
restored. 

When  from  two  to  five  minims  are  poured  on  lint  and  applied 
to  the  nostrils,  the  heart's  action  will  be  accelerated,  a  sudden 
flushing  of  the  face  takes  place,  dilatation  of  the  arteries  results, 
also  a  fall  in  the  blood  pressure  and  a  lowering  of  the  tempera- 
ture, and  complete  muscular  relaxation. 

Therapeutic  Uses.  By  inhalation,  for  relieving  the  pain  of 
angina  pectoris ;  also  used  in  asthma,  strychnia  poisoning, 
hydrophobia,  tetanus,  epileptic  attacks,  and  in  many  other 
convulsive  or  spasmodic  diseases. 

Dose.  Of  Nitrite  of  Amyl,  ttlIj  to  tt\^v,  by  inhalation ;  not 
more  than  gtt.  iij  should  be  administered,  unless  the  patient 
has  been  accustomed  to  its  use. 

Dental  Uses.  As  an  antidote  to  chloroform  narcosis,  for  the 
relief  of  epileptic  attacks  during  the  extraction  of  teeth,  for 
the  relieving  the  pain  of  neuralgia  of  the  fifth  pair  of  nerves,  and 
for  restoration  from  syncope.  As  nitrite  of  amyl  is  a  powerful 
and  dangerous  agent,  care  must  be  observed  in  its  use,  and 
but  small  doses  applied  at  first,  as  some  patients,  especially 
the  weak  and  nervous,  are  very  susceptible  to  its  influence. 


ARGENTI    NITRAS NITRATE    OF    SILVER.  153 

AQUA  DESTILLATA— DISTILLED  WATER. 

Derivation.  "  Take  of  water  80  pints.  Distill  two  pints, 
using  a  tin  or  glass  condenser,  and  throw  them  away ;  then 
distill  64  pints,  and  keep  them  in  glass  bottles." — U.  S.  D. 

Properties.  Distilled  water  has  a  vapid,  and  by  no  means 
pleasant  taste,  and  is  only  perfectly  pure  when  the  vessel  used 
in  the  distillation  is  of  silver.  It  should  evaporate  without 
residue. 

Therapeutic  Uses.  It  is  very  essential  in  the  preparation  of 
some  formulae,  and  of  no  use  whatever  in  others,  as  the  common 
pure  water  will  answer.  Such  agents  as  tartar  emetic,  nitrate 
of  silver,  corrosive  sublimate,  chlorides  of  calcium,  barium, 
acetate  and  subacetate  of  lead,  permanganate  of  potassa,  the 
sulphates  of  iron  and  zinc,  sulphate  of  quinia,  the  salts  of 
morphia,  and  all  the  alkaloids  and  their  salts,  require,  when 
given  in  solution,  distilled  water. 

Dental  Uses.  Distilled  water  is  required  in  the  preparation 
of  many  formulae  for  use  in  dental  practice. 

ARGENTI  NITRAS— NITRATE  OF  SILVER. 

Lunar  Caustic. 

Formula.     AgNOa. 

Derivation.  Nitrate  of  Silver  is  obtained  by  dissolving 
silver  in  nitric  acid  and  distilled  water,  and  evaporating  the 
solution.  It  is  in  the  form  of  a  heavy,  colorless,  anhydrous 
salt,  and  crystallizes  in  shining,  rhombic  plates.  The  action  of 
light  and  organic  matters  causes  it  to  turn  black.  It  is  wholly 
soluble  in  distilled  water,  the  only  preparation  of  water  that 
should  be  employed  in  forming  solutions  of  this  salt.  It  has 
a  strong,  metallic,  styptic  taste.  In  the  preparation  of  the  solid 
form  of  sticks,  it  is  first  melted  and  poured  into  moulds,  expo- 
sure to  the  light  causing  the  sticks  to  become  gray,  and  more 
or  less  dark,  owing  to  the  reduction  of  the  silver  by  the  sul- 
phuretted hydrogen  contained  in  the  atmosphere ;  hence,  on 
account  of  the  decomposition  of  this  salt,  it  should  be  carefully 
excluded  from  the  light. 
1 1 


154  DENTAL   MEDICINE. 


Medical  Properties  and  Action.  Nitrate  of  Silver  is  tonic, 
antispasmodic,  sedative,  and  astringent.  When  applied  to  the 
skin,  mucous  membrane,  or  ulcers,  it  produces,  at  first,  a  white 
appearance,  owing  to  its  union  with  the  coagulated  albumen  of 
the  cuticle,  but  this  gradually  changes  to  a  bluish-gray,  purple, 
and  finally,  black  color,  on  account  of  the  partial  reduction  of 
the  silver  by  the  sulphuretted  hydrogen.  Small  doses,  adminis- 
tered for  a  long  time,  give  a  peculiar  blue  appearance  to  the 
skin.  When  internally  administered,  it  has  an  astringent  action 
on  the  mucous  coats  of  the  intestines.  It  is  a  powerful  tonic 
to  the  nervous  system,  and  has  been  chiefly  employed  as  an 
antispasmodic  tonic.  It  is  chiefly  used  externally,  as  a  stimu- 
lant, vesicant,  and  escharotic.  If  applied,  even  lightly,  three 
or  four  times,  to  the  moistened  skin,  it  will  cause  vesication  in 
a  few  hours.  The  blue  appearance  on  the  skin,  when  small 
doses  are  long  continued,  is  said  to  be  preceded  by  a  peculiar 
blue  line  on  the  gums,  like  that  from  lead  poisoning.  A  very 
minute  quantity  of  this  salt,  when  internally  administered,  is 
eliminated  by  the  kidneys,  as  most  of  it  escapes  by  the  liver 
and  the  intestinal  glands,  a  portion  remaining  permanently 
deposited  in  the  tissues  when  its  use  has  been  long  continued. 
Six  weeks  is  the  length  of  time  it  is  safe  to  continue  its  internal 
use,  and  during  that  time  occasional  purgatives  should  be 
given,  to  promote  its  elimination.  The  persistent  use  of  iodide 
of  potassium  and  of  the  hyposulphite  of  soda  will  cause  the 
absorption  and  excretion  of  the  silver  deposits,  in  cases  of  skin 
discoloration  from  its  long  continued  use,  aided  by  baths  of  the 
hyposulphites,  and  the  very  careful  use  of  lotions  containing 
cyanide  of  potassium,  which  possesses  a  solvent  power  over 
silver  deposits.  As  long  as  inflammation  is  present,  it  should 
not  be  internally  administered,  and  during  a  course,  it  should 
be  occasionally  intermitted  for  a  few  days,  and  a  purgative  used. 
The  gums  and  fauces  should  be  frequently  examined,  and  if 
the  slightest  blue  discoloration  is  observed,  the  remedy  should 
be  discontinued.     Exposure  to  the  sun  should  be  avoided. 

Therapeutic  Uses.     Nitrate  of  Silver  is  internally  employed 
in  dyspepsia,  chronic  gastritis,  chronic  diarrhoea  and  dysentery, 


ARGENTI    NITRAS NITRATE  OF    SILVER.  1  55 

cholera,  diseases  of  the  eye,  chorea,  epilepsy,  asthma,  and 
whooping  cough. 

Externally  in  ophthalmia  and  other  diseases  of  the  eyes, 
cutaneous  diseases,  diphtheria,  erysipelas,  hydrophobia,  enlarge- 
ment of  glands,  diseases  of  the  genito-urinary  organs,  diseases 
of  the  ear,  burns,  ulcers,  etc.,  etc. 

Dose.  Of  Nitrate  of  Silver,  gr.  yi,  gradually  increased  to 
gr.  y^  three  times  a  day,  in  pill  made  of  some  vegetable  pow- 
der, or  in  solution.  The  fused  nitrate  of  silver — Argenti  Nitras 
Fusa — -or  solid  form,  is  used  externally. 

Dental  Uses.  For  inflamed  and  ulcerated  conditions  of  the 
mucous  membrane  of  the  mouth,  nitrate  of  silver  is  a  valuable 
application,  in  the  form  of  injections  or  solutions  of  various 
strengths,  from  gr.  ij  to  5ss  of  distilled  water;  also  in  diseases 
of  the  antrum  and  fistula,  as  an  injection.  *  It  is  also  used  as  a 
styptic,  for  the  arrest  of  alveolar  hemorrhage,  but  is  not  so 
reliable  as  the  preparations  of  iron,  tannic  acid,  etc  ,  on  account 
of  the  coagulum  or  clot  formed  by  it,  being  soluble  in  an  excess 
of  albumen.  It  is  also  employed  to  obtund  the  sensitiveness 
of  dentine,  especially  where  the  cause  is  mechanical  abrasion  ; 
also  in  aphthae,  mercurial  stomatitis,  ulceration  of  the  gums, 
salivary  fistula,  alveolar  abscess.  For  obtunding  sensitive 
dentine,  the  stick  form  (one  end  of  a  stick  inserted  into  a  quill, 
or  fused  on  the  end  of  a  platinum  wire),  is  employed ;  or  the 
end  of  a  silver  wire  may  be  immersed  in  nitric  acid,  and  applied 
to  the  sensitive  surface,  taking  care  to  limit  its  action  to  the 
part  on  which  it  is  to  act.  When  applied  to  sensitive  dentine, 
it  acts  on  the  gelatinous  portion  of  the  tooth,  destroying  its 
vitality  to  the  extent  of  the  combination  which  takes  place. 
The  objection  to  its  use  in  such  cases  is  the  discoloration  it 
causes. 

As  salt  decomposes  the  nitrate  of  silver,  a  solution  of  the 
chloride  of  sodium  will  relieve  the  excessive  pain  following  its 
application  to  sensitive  dentine,  or  to  ulcers  of  the  mouth ; 
such  a  solution  will  also  remove  recent  stains,  if  followed  by 
the  application  of  a  solution  of  ammonia.  Old  stains  may  be  re- 
moved with  tincture  of  iodine,  followed  by  cyanide  of  potassium. 


156  DENTAL   MEDICINE. 


The  antidote  in  cases  of  poisoning  by  nitrate  of  silver  is 
chloride  of  sodium  (common  salt),  which  converts  it  into  chlo- 
ride of  silver,  to  be  followed  by  emetics,  and  the  proper  anti- 
phlogistic treatment. 

DENTAL  FORMULAE. 

For  Inflamed  and   Ulcerated  Mucous  For  Disease  of  the  Antrum. 

Membrane.  R  .     Argenti  Nitratis..gr.  j  to  gr.  v 

R.     Argenti  Nitratis..gr.ij  to 3 ss  Aquae  Destillatse fgj.      M. 

Aquae  Destillatse f^j.      M.  SiGNA. — To  be  used  as  an  injection. 

SiGNA. — To  be  used  as  a  lotion.  For  Ulcers  and  Aphthce. 

For  Mercurial  Stomatitis.  R.     Argenti  Nitratis ^ss 

R.     Argenti  Nitratis gr.  ss  Aquse  Destillatce. 1^].        M. 

Aquse  Destillatse.. f^j.      M.  SiGNA. — To  be  applied  with  a  camel- 

SiGNA. — To  be  used  as  a  mouth-wash.  hair  brush. 

ARNICA— ARNICA. 
Leopard's  Bane. 

Source.  Arnica  Montana  is  a  perennial,  herbaceous  plant, 
of  which  the  dried  flowers  and  root — Arnicm  Flores  and  Arnicce 
Radix — are  the  medicinal  portions,  and  is  found  in  the  mountains 
of  Northern  Europe  and  the  Northwestern  portions  of  America. 

Medical  Properties  and  Action.  Arnica  is  nervine,  stimulant, 
and  diaphoretic.  In  over  doses,  it  is  an  acro-narcotic  poison, 
causing  vomiting,  purging,  vertigo,  tetanic  twitchings  of  the 
muscles,  and  convulsions.  Moderate  doses,  when  long  con- 
tinued, are  liable  to  cause  a  very  troublesome  eruption.  Its 
activity  depends  upon  an  alkaloid — Arjiicina,  which  is  a  bitter 
and  acrid  extractive. 

Therapeutic  Uses.  Arnica  is  administered  internally  in 
typhus  and  typhoid  fevers,  chronic  dysentery,  rheumatic  gout, 
etc.,  etc.  Externally  to  bruises,  sprains,  lacerations,  chilblains, 
etc.,  in  the  form  of  tincture — Tinctura  Arnica.  The  antidote 
for  poisoning  by  arnica  is  common  vinegar. 

Dose.  Of  the  Extract  of  Arnica,  gr.  v  to  gr.  x.  Of  the 
Tincture  of  Arnica  (arnica  root  oj,  rectified  spirit,  Oj),  the  dose 
is  n\,x  to  foss. 

Dental  Uses.  In  dental  practice,  the  tincture  of  arnica  is 
applied  to  irritable  pulps  of  teeth,  in  dental  periostitis,  to  pre- 


ATR0PIN7E    SULPHAS SULPHATE    OF    ATROPINE.  157 

vent  suppuration,  to  wounds  of  the  mucous  membrane  of  the 
mouth,  combined  with  glycerine,  to  abraded  surfaces  caused 
by  artificial  teeth,  and  with  tannic  acid  or  glycerine  of  tannin, 
for  ulcers  of  the  mouth. 

The  tincture  of  arnica,  when  largely  diluted  with  water, 
forms  an  efficient  mouth-wash  during  operations  upon  the 
teeth. 

DENTAL  FORMUL.^. 

For  Abraded  Surfaces  of  the  Mucous     For   Inflamed  and   Ulcerated  Mucous 
Membrane  of  the  Mouth.  Membrane. 

R.     Tincturse  Arnicag  R.     Tincturse  Arnicse ^ij 

Glycerini aa.......  3J.        M.  Glycerini '7^\] 

SiGNA. — To  be  used  as  a  lotion.  Aquae  Rosse ^^  ij 

Aquse  Destillatse "f^  x.       M. 

SiGNA. — To  be  used  as  a  gargle. 

For  Ecchymosis. 

R  .     Tincturae  Arnicse f^  ss 

Liquor  Ammonii  Muriat ^  ss 

Aquae ^  v.  M. 

SiGNA. — To  be  applied  as  a  lotion. 

ATROPIN.E  SULPHAS— SULPHATE  OF  ATROPINE. 

Atropine. 

Formula.     C17H23NO3. 

Derivation.  Sulphate  of  atropine  is  obtained  by  adding  a 
mixture  of  sulphuric  acid  to  an  ethereal  solution  of  atropine. 
It  is  in  the  form  of  a  white,  slightly  crystalline  powder,  very 
soluble  in  water  and  alcohol,  but  insoluble  in  ether.  It  is 
inodorous,  and  of  a  bitter  taste. 

Medical  Properties  and  Action.  Sulphate  of  atropine  has  the 
same  medical  properties  and  action  as  belladonna,  but  is  far 
more  energetic  in  its  action.  It  is  an  active  poison,  and  should 
only  be  administered  internally  with  the  greatest  care.  Hypo- 
dermically  employed,  it  is  a  useful  anodyne  and  antispasmodic, 
and  the  quantity  should  be  cautiously  increased  from  a  very 
small  dose  in  the  beginning.  Such  symptoms  as  dryness  of 
the  throat,  vertigo,  and  diplopia,  are  indications  that  its  use 
should  be  discontinued.     Without  being  a  direct  hypnotic,  it 


158  DENTAL   MEDICINE. 


induces  sleep  by  relieving  pain.  Although  it  is  not  so  well 
tolerated,  as  a  general  rule,  as  is  morphia,  yet  patients  who 
cannot  bear  morphia  will  bear  atropia. 

Therapeutic  Uses.     See  Belladonna. 

Dose.  Of  Sulphate  of  Atropine,  gr.  xl^  to  gr.  -h.  For  an 
anodyne  and  antispasmodic,  hypodermically  injected,  the  dose 
is  •n\^ij  =  gr.  ih,  as  a  commencement.  An  ointment  is  made  of 
atropine,  gr.  viij,  rectified  spirit,  f5ss,  lard,  Sj. 

The  antidote  in  cases  of  poisoning  by  belladonna  and  its 
alkaloid  is  an  infusion  of  galls  and  lime  water,  first  evacuating 
the  stomach  as  speedily  as  possible. 

De?ital  Uses.  In  dental  practice,  sulphate  of  atropine  is 
applied  externally,  to  obtund  the  sensitiveness  of  inflamed 
pulps  of  teeth,  preparatory  to  other  treatment,  and  to  their 
devitalization  ;  it  is  also  applied  in  acute  inflammation,  depend- 
ing upon  alveolar  periostitis  and  abscess.  It  forms  one  of  the 
ingredients  of  a  nerve  paste,  for  devitalizing  pulps  of  teeth, 
being  substituted  for  the  acetate  of  morphia ;  in  facial  neu- 
ralgia, in  the  form  of  an  ointment ;  in  neuralgia  and  in  profuse 
salivation.  As  an  anodyne  for  internal  use,  it  proves  efficacious 
in  relieving  intense  pain,  such  as  may  result  from  an  inflamed 
pulp  or  periosteum ;  also  internally,  or  in  the  form  of  hypo- 
dermic injections,  for  the  relief  of  facial  neuralgia. 

DENTAL  FORMULA. 

J^or  Facial  Neuralgia.  For  Facial  Neuralgia. 

R.     Atropinae  Sulphat gr.  j  R.     Ext.  Belladonnae gr- ss 

Adipis 5J.        M.  Quininae  Sulphat gr- ij-    M. 

SiGNA. — To  be  applied  in  the  form  of  Ft.  pil.  No.  i. 

an  ointment,  over  seat  of  pain.  SiGNA. — Use  three  times  daily. 

For  Facial  Neuralgia.  For  Facial  Neuralgia. 

R.     Pulveris  Belladonnas...  _^  X  R.     Linimenti  Belladonnae 

Camphorse ^ss  Linimenti  Aconiti„aa..  3  vij 

Spiritus  Rectificati q.  s.      M.  Chloroformi f^ij-      M. 

SiGNA. — To  be  applied  with  a  camel-  Signa. — To  be  applied  as  a  lotion,  on 

hair  brush.  lint  saturated  with  it,  and  covered  with 

oiled  silk. 


AURUM  TERCHLORIDUM TERCHLORIDE  OF  GOLD.    159 

Fo7'  New-algia.  For  Neuralgia  in  Superficial  Nerves. 

R.     Ext.  Belladonnse gr- iv  R.     Chloroformi 

Ext.  Stramonii gr- v  Spts.  Vini  Rect aa...^ss 

Ext.  Hyoscyami gr.  v  Atropinse  Sulphat gr.v.     M. 

Quininse  Sulphat ^  'J-  ^-  SiGNA. — To  be  applied  on  lint  to  painful 

Ft.  pil.  No.  XX.  part,  and  covered  with  oiled  silk. 
SiGNA. — One  pill  two  or  three  times  a 
day. 

AURUM  TERCHLORIDUM— TERCHLORIDE  OF 

GOLD. 

Formula.     AUCI3. 

Derivation.  The  Terchloride  of  Gold  is  obtained  by  dissolv- 
ing gold  in  aqua  regia  (three  parts,  by  measure,  of  hydrochloric 
acid,  and  one  of  nitric  acid),  using  gentle  heat  to  hasten  the 
solution,  the  acids  employed  being  chemically  pure.  The 
solution  is  then  evaporated  to  dryness,  when  ruby-red,  prism- 
atic crystals  of  the  terchloride  of  gold  result. 

Properties  and  Action.  Terchloride  of  Gold  is  very  deli- 
quescent, and  is  soluble  in  water,  alcohol  and  ether.  It  pos- 
sesses a  disagreeable,  styptic  taste,  reddens  blue  litmus  paper, 
and  will  impart  a  purple  stain  to  the  skin,  which  may  be 
removed  by  a  solution  of  cyanide  of  potassium.  It  is  readily 
decomposed  by  many  metallic  and  non-metallic  elements,  and 
also  by  saline  and  organic  compounds,  on  account  of  its  elements 
being  held  together  by  a  feeble  affinity.  It  is  escharotic  and 
disinfectant,  and  its  physiological  effects  are  similar  to  those 
of  corrosive  sublimate.     It  is  not  used  internally. 

Dental  Uses.  In  dental  practice,  the  Terchloride  of  Gold,  in 
the  form  of  an  aqueous,  alcoholic,  or  ethereal  solution,  is 
employed  for  the  purpose  of  obtunding  the  sensitiveness  of 
dentine,  for  which  it  is  a  valuable  application  ;  and  the  ethereal 
solution  possesses  some  advantages  over  the  aqueous  or  alco- 
holic solutions,  for  such  a  purpose.  To  prepare  an  obtunding 
solution :  "  Dissolve  the  crystals  of  the  gold  in  pure  water ; 
fill  a  test  tube  half  full  of  the  solution ;  then  add  an  equal 
quantity  of  sulphuric  ether,  and  agitate  the  mixture.  Let  it 
then  rest  a  few  minutes,  when  the  ethereal  solution  will  rise  to 
the  surface,  and  may  be  poured  off  into  another  tube  or  phial. 


160  DENTAL    MEDICINE. 


and  securely  stopped.  It  should  be  kept,  as  much  as  practic- 
able, from  the  action  of  light  and  air.  Applied  to  dentine,  on 
pledgets  of  cotton,  it  acts  like  chloride  of  zinc,  but  more 
promptly  and  with  less  pain.  Chlorine  is  more  abundantly 
liberated  during  its  action  than  from  chloride  of  zinc,  hence  it 
is  a  better  disinfectant  than  the  latter."  It  has  a  fine  yellow- 
tint,  and  it  is  not  absorbed  by  the  dentine,  but  forms  an  insolu- 
ble compound  with  the  gelatinous  elements.  As  it  is  an 
irritant  poison,  care  should  be  observed  in  its  use.  If  not 
protected  in  a  glass-stoppered  bottle,  the  gold  is  precipitated  in 
a  metallic  form. 

BELLADONNA    FOLIA— BELLADONNA    LEAVES. 
BELLADONNyE  RADIX— BELLADONNA  ROOT. 

Deadly  Nightshade. 

Source.  Belladonna  is  a  perennial,  herbaceous  plant,  found 
in  Europe,  the  leaves  and  root  being  the  medicinal  portions. 

Medical  Properties  and  Actioit.  Belladonna  is  anodyne  and 
antispasmodic,  its  activity  depending  upon  an  alkaloid,  Atro- 
pine. Belladonna,  in  small  doses,  is  a  valuable  narcotic  and 
anodyne  stimulant,  having,  however,  little  or  no  influence  on 
the  circulation,  or  any  of  the  secretions,  except  causing  a 
peculiar  dryness  of  the  mouth  and  fauces.  In  larger  doses,  it 
causes  dilatation  of  the  pupils,  giddiness,  loss  of  vision,  diffi- 
cult deglutition,  constriction  of  the  throat,  difficult  articulation, 
increased  action  of  the  heart,  quickened  respiration,  nausea, 
vomiting,  diuresis,  purging,  and  sometimes  a  red  eruption.  It 
is  eliminated  chiefly  by  the  urine. 

Opium  is  the  antidote,  or  hypodermic  injections  of  morphia. 
When  applied  to  the  eyebrows,  belladonna  causes  dilatation  of 
the  pupils. 

Therapeutic  Uses.  Belladonna  is  extensively  employed,  either 
alone  or  in  combination  with  sulphate  of  quinia,  in  the  treatment 
of  neuralgia ;  also  in  mania,  Bright's  disease,  epilepsy,  lead 
colic,  spasmodic  affections,  diseases  of  the  cerebro-spinal  sys- 
tem, as  a  preventive  of  scarlatina,  night  sweats  of  phthisis, 
etc. 


BISMUTHI    SUBNITRAS SUBNITRATE    OF    BISMUTH.  IGl 

Dose.  Of  powdered  Belladonna,  gr.  ss  to  gr.  j,  daily;  of  the 
extract,  gr.  ^  to  gr.  j ;  of  the  tincture,  gtt.  v  to  gtt.  xx. 

BISMUTHI  SUBNITRAS— SUBNITRATE  OF 
BISMUTH. 

Formula.     BiONOgHaO. 

Derivation.  The  metal  Bismuth — Bismiithiim,  Fornmla  Bi, 
from  which  the  subnitrate  is  obtained,  is  found  native  in  Europe 
and  America,  and  generally  in  combination  with  sulphur  and 
oxygen.  It  fuses  at  476°  F.,  and  is  brittle  and  pulverizable. 
It  is  employed  in  the  dental  laboratory  for  making  fusible 
metal  alloys  for  dies  and  counter-dies. 

The  Subnitrate  of  Bismuth  is  obtained  by  dissolving  the 
metal  bismuth  in  dilute  nitric  acid,  and  converting  the  nitrate 
thus  formed  into  carbonate,  by  adding  a  solution  of  carbonate 
of  sodium,  which  is  then  dissolved  in  nitric  acid,  and  the  nitrate 
of  bismuth  again  formed,  which  is  washed  in  water,  and  the 
nitric  acid  removed  by  ammonia.  Such  a  process  frees  it  from 
the  arsenious  acid  which  metallic  bismuth  generally  contains. 
Subnitrate  of  bismuth  is  in  the  form  of  a  heavy,  white  powder, 
with  a  faint  acid  odor  and  slightly  metallic  taste,  and  is  insoluble 
in  water.  Large  quantities  are  poisonous,  with  symptoms  of 
arsenical  poisoning. 

Medical  Properties  and  Action.  Subnitrate  of  bismuth  is 
sedative,  astringent,  and  alterative.  Owing  to  the  formation 
of  a  sulphide,  it  coats  the  tongue  black,  and  its  continued  use 
may  give  rise  to  the  formation  of  a  bluish-red  line  on  the  gums, 
similar  to  that  resulting  from  the  use  of  lead,  except  that  the 
line  is  wider  and  deeper  in  color.  In  proper  doses,  it  promotes 
the  appetite  and  increases  the  digestive  power.  Being  some- 
what astringent,  it  affects  the  intestinal  movements,  and  can  be 
detected  in  the  blood,  urine,  and  other  secretions. 

Therapeiitic  Uses.  Subnitrate  of  bismuth  is  employed  in 
atonic  dyspepsia,  gastric  irritations  (milder  forms),  pyrosis, 
gastrodynia,  ulcer  of  the  stomach,  diarrhoea  from  debility,  etc., 
chronic  laryngitis,  epilepsy,  ringworm  (in  form  of  an  ointment 
5j  to  lard  5j),  chronic  skin  diseases,  chlorosis,  when  iron  is  not 


162  DENTAL    MEDICINE. 


tolerated,  etc.,  etc.  If  not  well  borne  by  the  stomach,  it  may 
be  combined  with  aromatic  powder,  or  if  alkalies  are  indicated, 
with  chalk  and  magnesia. 

Dose.  Of  Subnitrate  of  Bismuth,  gr.  v-x  to  5j,  in  powder 
or  emulsion. 

Dental  Uses.  Subnitrate  of  bismuth  is  a  valuable  internal 
remedy  in  aphthae,  mercurial  salivation,  painful  ulcers  of  the 
mucous  membrane  of  the  mouth,  vomiting,  cholera  infantum, 
and  diarrhoea  of  children  during  painful  dentition.  It  is  best 
given  in  milk,  and  before  meals. 

DENTAL  FORMULA. 

For  Vomiting  and  Painful  Digestion  of  For  Diarrhoea  of  Dentition 

Teething  Children,  Acidity  and  Pyro-  R .     Bismuthi  Subnitrat gr.  Ix 

sis.  Extract  Rhei  Fluid gtt.  viij 

Bartholow.  Syrup  Rubus f^ss 

R.     Bismuthi  Subnitrat ^iij  Elixir  Aurantii f^ss.      M. 

Acid.  Carbol gr.  ij-gr.  iv.  SiGNA. — A  teaspoonful  four  to  six  times 

Mucil.  Acaciae ,^j  aday.    Proper  feeding — barley  water, 

Aquae  Menthae  Pip 5  iij.        M.  milk  and  lime  water.     Starchy  food 

SiGNA. — A  tablespoonful  for  adults,  and  prohibited, 
a  proportionate  quantity  for  children, 
three  or  four  times  a  day. 

CALCII   HYPOPHOSPHIS— HYPOPHOSPHITE  OF 

LIME. 

Formula.     CajPHjOj. 

Derivatio7i.  The  salt,  Hypophosphite  of  Lime,  is  obtained 
by  boiling  phosphorus  in  a  mixture  of  hydrate  of  lime  in  boil- 
ing water,  until  phosphoretted  hydrogen  escapes,  and  phosphate 
and  hypophosphite  of  lime  are  formed  in  the  solution,  which  is 
then  filtered  and  evaporated  over  sulphuric  acid,  when  the  salt 
is  crystallized  out  in  the  form  of  white,  pearly  crystals,  with  a 
nauseous,  bitter  taste.  It  is  soluble  in  six  parts  of  water,  but 
is  insoluble  in  alcohol. 

Medical  Properties  and  Action.  The  Hypophosphite  of  Lime, 
with  those  of  soda  and  potassa,  are  all  included  under  the 
term  "  alkaline  sulphites."  Taken  internally,  they  are  readily 
absorbed,  and  are  partially  changed  in  the  system  into  sul- 
phates.    They  combine  with  acids  to  form  salts,  and  they 


CALENDULA CALENDULA.  163 

dissolve  albumen,  and  increase  the  formation  of  saliva.  Being 
regarded  as  tonic,  alterative,  stimulant  and  nervine,  they  are 
employed  in  cases  of  debility,  more  especially  where  the  phos- 
phates are  deficient,  as  they  possess  the  therapeutic  properties 
of  phosphorus. 

Therapeutic  Uses.  The  different  sulphites  of  lime,  soda, 
and  potassa,  are  employed  in  intermittent  and  malarious  fevers, 
typhus  fever,  smallpox,  and  other  exanthematous  diseases, 
pyaemia,  dyspepsia,  neuralgia  with  nervous  depression,  anaemia, 
for  which  affection  they  are  combined  with  iron  and  quinine  ; 
diphtheria,  cystitis,  phthisis,  etc.,  etc.  Externally,  the  sulphites 
are  efficient  as  local  applications  (especially  the  sulphites  of 
soda),  in  gangrenous  and  other  ulcerations,  diseases  of  the 
skin,  etc.  One  or  two  ounces  to  the  pint  of  water  form  a 
stimulant  and  deodorizing  lotion,  which  is  promotive  of  healthy 
action. 

Dose.  Of  the  hypophosphites,  gr.  iij  to  gr.  xv,  three  times 
a  day,  in  syrup. 

Dental  Uses.  The  hypophosphite  of  lime  is  the  most  eligible 
salt,  but  the  different  sulphites  are  often  administered  together, 
in  the  form  of  a  syrup.  Where  there  is  nervous  depression, 
as  a  result  of  trigeminal  neuralgia,  the  hypophosphites  prove 
serviceable.  The  hypophosphite  of  lime  is  recommended  in 
the  case  of  delicate  children,  where  there  is  reason  for  believing 
the  phosphate  of  lime,  or  the  lime  salts  generally  of  the  teeth, 
are  deficient  in  quantity. 

CALENDULA— CALENDULA. 
Marigold. 

Source.  Calendula  is  a  well  known  garden  plant,  sometimes 
growing  wild,  with  a  peculiar  and  rather  disagreeable  odor, 
and  a  bitter,  rough,  saline  taste.  Both  the  leaves  and  the 
flowers  are  employed. 

Medical  Properties  and  Action.  It  is  slightly  stimulant,  dia- 
phoretic, antispasmodic,  sudorific,  and  emmenagogue,  but  is 
seldom  used  internally.  It  contains  a  bitter  principle,  known 
as  calendidin. 


164  DENTAL    MEDICINE. 


The7'apeiitic  Uses.  Calendula  has  been  employed  in  low 
forms  of  fevers,  scrofula,  jaundice,  amenorrhcea,  etc.  Externally, 
it  is  used  in  the  form  of  tincture — Tinctura  Calendula — in  its 
full  strength  or  diluted,  and  is  very  serviceable  in  exercising  a 
curative  influence  in  the  treatment  of  incised  wounds  and 
contusions,  preventing  inflammation  and  suppuration.  Some 
writers  consider  it  to  be  unequaled  as  a  local  application  after 
surgical  operations,  as  it  promotes  union  by  first  intention.  It 
is  applied  as  a  lotion  on  lint.  It  is  also  thought  to  be  a  prevent- 
ive against  gangrene  and  tetanus. 

Dose.     Of  the  Tincture  of  Calendula,  f5j  to  f5ij. 

Dental  Uses.  Calendula,  in  the  form  of  tincture,  is  employed 
in  dental  practice  as  an  application  to  wounded  or  irritated 
pulps  of  teeth,  when  partly  exposed ;  also,  after  the  extraction 
of  teeth ;  wounds  about  the  mouth ;  and  for  such  uses,  it 
proves  a  very  useful  remedy.  A  few  drops  added  to  a  wine- 
glass of  water,  forms  a  soothing  and  efficient  mouth-wash  for 
the  soreness  resulting  from  the  removal  of  salivary  calculus ; 
superficial  inflammations  of  the  mucous  membrane  of  the 
mouth,  etc. 

CALX— CALCIUM. 

Lime. 

Formula.     CaO. 

Derivation.  Lime  is  obtained  by  calcining  limestone  or 
chalk,  until  the  carbonic  acid  is  driven  off.  Lime  is  more 
soluble  in  cold  than  in  hot  water,  and  a  compound  of  lime  and 
sugar  is  more  soluble  in  water  than  pure  lime  alone.  Calcium 
is  the  metallic  base  of  lime. 

Medical  Properties  and  Action.  Quicklime  is  a  powerful 
escharotic  and  irritant. 

Liquor  Calcis — Lime  Water.  It  is  prepared  by  adding 
cold  water  to  freshly  slaked  lime,  and  the  clear  fluid  poured 
off". 

The  officinal  preparation  consists  of  four  troy  ounces  of 
saturated  solution  of  lime  in  eight  pints  of  distilled  water.  It 
is  a  colorless,  inodorous  liquid,  possessing  a  disagreeable  alka- 
line taste. 


CALX CALCIUM.  165 


Exposure  to  the  air  causes  it  to  gradually  absorb  carbonic 
acid,  with  the  formation  of  insoluble  carbonate  of  lime,  and  it 
should  therefore  be  preserved  in  glass-stoppered  bottles.  The 
addition  of  liquorice  or  coriander  seed  will  disguise  its  taste. 

Medical  Properties  and  Action.  Lime  water  is  antacid, 
astringent,  antiseptic  and  detergent.  It  is  applicable  to  all 
cases  where  antacids  are  indicated,  and  where  an  astringent 
effect  is  not  objectionable. 

Therapeutic  Uses.  "  Lime  water  is  an  excellent  remedy  in 
gastric  irritation,  accompanied  with  nausea  and  vomiting ;  also 
in  dyspepsia,  attended  with  vomiting  of  food;  also  in  diarrhoea, 
after  the  inflammatory  action  has  been  relieved;  also  in  gland- 
ular affections,  as  an  alterative  resolvent.  Externally,  as  a  wash 
for  foul  ulcers,  diseases  of  the  skin,  and  as  an  injection  in  gleet 
and  leucorrhoea.  Atomized  inhalations  have  been  found  useful 
in  diphtheria  and  membranous  croup. 

Dose.  Of  Lime  Water,  fSss  to  fSiij  or  iv,  several  times  a 
day.  It  may  be  mixed  with  an  equal  quantity  of  milk  for 
internal  use. 

Lime  Liniment — Linimentuni  Calcis  (lime  water,  foviij,  flax- 
seed oil,  ovij),  is  a  valuable  application  to  burns,  scalds,  and  in 
smallpox. 

Dental  Uses.  In  dental  practice,  lime  water  is  a  useful  agent 
in  the  form  of  a  gargle,  where  the  secretions  of  the  mouth  are 
viscid  and  fetid,  and  especially  where  the  teeth  are  soft  in 
structure  and  exceedingly  sensitive,  owing  to  the  condition  of 
the  oral  fluids,  and  especially  of  mucous  secretions,  which  act 
readily  on  teeth  deficient  in  earthy  constituents.  For  young 
patients,  the  use  of  lime  water  is  very  beneficial  to  the  teeth, 
owing  to  an  acid  condition  of  the  oral  fluids,  common  to  an 
early  period  of  life.  It  is  also  useful  where  the  teeth  are  very 
sensitive,  on  account  of  the  recession  of  the  gum  and  absorp- 
tion of  the  process. 

When  lime  water  is  applied  to  inflamed  mucous  membrane, 
or  to  suppurating  surfaces,  it  arrests  secretion.  It  is  also 
useful  in  sickness  and  irritability  of  the  stomach  during  denti- 
tion ;  also  to  relieve  the  superficial  ulceration  of  the  mucous 


166  DENTAL   MEDICINE. 


membrane  of  the  mouth,  caused  by  the  acid  eructations  attend- 
ing dyspepsia,  in  the  proportion  of  one  part  of  hme  water  to 
two  or  three  of  milk. 

CALX  CHLORATA— CHLORINATED   LIME. 
Chi^oride  of  Lime. 

Formula.     CaClaOajCaClj. 

Derivation.  Chloride  of  Lime  is  obtained  by  passing  chlor- 
ine over  hydrate  of  lime  till  saturation  is  effected.  It  is  in  the 
form  of  a  grayish-white  substance,  either  in  powder  or  friable 
masses,  dry  or  but  slightly  moist.  It  is  readily  soluble  in 
water,  and  will  absorb  moisture  when  exposed  to  the  air.  It 
has  a  bitter,  caustic  taste,  and  a  slight  odor  of  chlorine. 

Medical  Properties  ajid  Action.  Chloride  of  lime  is  a  stimu- 
lant, deodorizer,  disinfectant,  antiseptic  and  bleaching  agent. 
In  small  doses  it  increases  the  action  of  the  secreting  organs, 
and  if  long  continued  it  acts  specifically  upon  the  lymphatic 
glandular  system,  causing  the  reduction  or  absorption  of  glan- 
dular and  other  tumors.  In  large  doses  it  acts  as  an  acro- 
narcotic  poison,  and  its  use  should  always  be  commenced  in 
small  doses,  carefully  increased,  and  discontinued  when  such 
symptoms  as  nausea,  vomiting  or  giddiness  appear.  It  is 
chiefly  used  as  a  disinfectant. 

Therapeutic  Uses.  Solutions  of  chlorinated  lime  are  em- 
ployed locally  in  scarlet  fever,  diphtheria,  aphthae,  gangrene ; 
and  it  has  been  administered  internally  in  scrofula,  typhus,  malig- 
nant scarlet  fever,  syphilis,  etc. 

Dose.  Of  Chloride  of  Lime,  gr.  j  to  gr.  v,  in  solution,  sev- 
eral times  a  day.  As  a  wash,  i  part  dissolved  in  lOO  parts  of 
water. 

Dental  Uses.  Chloride  of  lime  is  employed  in  dental  prac- 
tice in  the  treatment  of  cancrum  oris ;  one  method  of  applica- 
tion being  the  introduction  of  the  dry  powder,  with  the  point 
of  the  finger,  to  the  ulcerated  surface,  and  the  mouth  well 
washed  out  immediately  afterwards ;  also,  in  the  form  of  a 
gargle  composed  of  i  part  of  powdered  chloride  of  lime  to  30 
parts  of  mucilage  and  15  parts  of  syrup.     Solutions  of  chlor- 


CALX    CHLORATA CHLORINATED    LIME.  167 

ide  of  lime  are  also  efficient  in  scorbutic  and  other  ulcerations 
of  the  mouth.  It  is  also  employed  to  correct  the  fetor  of  the 
breath,  in  the  form  of  a  mouth-wash,  prepared  as  a  weak  so- 
lution. 

One  of  its  most  important  uses  in  dental  practice  is  as  a 
bleaching  agent,  either  alone  or  in  combination  with  other 
substances,  to  restore  the  color  of  devitalized  teeth.  When 
chlorinated  lime  is  employed  for  bleaching  discolored  teeth,  a 
good  quality  should  be  obtained,  and  no  steel  instrument  used 
for  its  introduction ;  wood  or  gold  instruments  are  to  be  pre- 
ferred, and  the  chloride  should  be  perfectly  dr}^,  and  have  been 
kept  so  from  the  time  it  was  made.  An  efficient  bleaching 
preparation  is  composed  of  equal  parts  of  dry  chlorinated  lime 
and  tartaric  acid,  mixing  them  together  dry,  and  adding  a  little 
of  the  acid  at  a  time.  When  prepared,  the  mixture  should  be 
kept  in  a  glass-stoppered  bottle.  For  bleaching  purposes, 
chlorinated  lime  is  also  combined  with  chloroform,  in  the  form 
of  a  thin  paste.  When  chlorinated  lime,  or  its  combinations, 
is  introduced  into  the  cavity  of  a  tooth,  it  should  be  secured 
by  a  temporary  filling  of  gutta  percha,  Hill's  Stopping,  or  one 
of  the  zinc  preparations,  and  be  secured  from  passing  beyond 
the  foramen  of  the  root,  by  a  filling  introduced  near  the  apex 
of  the  root.  More  than  one  application  may  be  required,  after 
which  the  cavity  should  be  thoroughly  cleansed,  and  a  tempor- 
ar}^  filling  of  the  whitest  shade  of  the  oxy-chloride  of  zinc 
filling  material  be  introduced  and  w^orn  for  some  time,  after 
which  a  more  durable  gold  filling  can  be  inserted. 

DENTAL  FORMULAE. 

For  Gangrene  of  the  Mouth — Cancrutn  For  Fetor  of  the  Breath. 

Oris.  Bartholow. 

Bartholow.  R.     Calc.  Chloral jiij 

R.     Calc.  Chloral ^ss  Aquse  deslil ^  i j 

Mucilaginis ^ss  Alcoholis ^ij 

Aquae  destil ^iiiss.  M.  01.  Rosse gtt.  iv.  M. 

SiGNA. — To  be  used  as  a  lolion.  Signa. — A  leaspoonful  in  a  lumblerful 

of  water  ;  used  as  a  gargle. 


168  DENTAL    MEDICINE. 


CAMPHORA— CAMPHOR. 

Formula.     CioHiqO. 

Source.  Camphor  is  a  concrete  substance  obtained  from  the 
camphor  laurel,  an  evergreen  tree  of  China,  Japan  and  For- 
mosa, by  sublimation,  the  crude  gum  being  purified  by  resubli- 
mation  with  quicklime.  Refined  camphor  is  in  the  form  of 
large,  circular  cakes,  one  or  two  inches  thick,  and  has  a  strong, 
penetrating,  fragrant  odor,  and  a  bitter,  pungent  taste,  attended 
with  a  slight  sense  of  coolness.  It  is  white,  pellucid,  and 
somewhat  unctuous  to  the  touch. 

Medical  Properties  and  Action.  Camphor  is  anodyne,  stimu- 
lant, refrigerant,  diuretic,  and  diaphoretic.  It  increases  the 
action  of  the  heart  and  arteries,  and  renders  the  pulse  softer 
and  fuller;  but  such  effects  are  very  transitory,  and  are  followed 
by  depression.  In  large,  but  not  over  doses,  it  allays  pain  and 
spasm,  and  induces  sleep.  In  over  doses,  it  excites  narcotic 
symptoms,  with  those  of  an  irritant  poison,  and  has  proved 
fatal.     It  acts  chiefly  on  the  nervous  system. 

Therapeutic  Uses.  Camphor  is  administered  in  fevers  of  an 
asthenic  type,  acute  inflammations,  inflammation  of  the  brain, 
delirium  tremens,  asthma,  rheumatic  and  nervous  headaches, 
diseases  of  the  heart,  hysteria,  dysentery,  diarrhoea,  cholera, 
etc.,  etc.  Externally  as  an  anodyne  in  rheumatism,  and  as  a 
discutient  in  chronic  inflammatory  affections ;  also,  the  powder 
as  a  snuff  in  coryza  and  influenza,  and  in  the  form  of  Camphor 
Liniment — Linimejitum  CamphorcE — (camphor  i  part,  olive  oil 
4  parts). 

Camphor  Water — Aqua  Caniphorce — (camphor  gr.  cxx, 
alcohol  111  xl,  carbonate  of  magnesia  oss,  distilled  water  Oij). 

Soap  Liniment — Linimeiitum  Saponis — (camphor  Siv,  oil  of 
rosemary,  foss,  alcohol  Oij,  water  ovj)  is  an  anodyne  and 
gentle  rubefacient  for  sprains,  rheumatic  and  gouty  pains. 

Spirit  of  Camphor — Spiritus  Camphor(B — (camphor  oiv, 
alcohol  Oij). 

Dose.     Of  camphor  in  substance,  gr,  ij  to  gr.  x,  in  form  of 


CALX    CHLORATA CHLORINATED    LIME.  169 

an  emulsion,  made  of  sugar,  gum  arable,  myrrh,  and  water. 
Of  camphor  water  5j  to  5j ;  of  spirit  of  camphor  n\,v  to  tt\^xx. 

Dental  Uses.  In  dental  practice,  the  spirit  of  camphor  is 
locally  employed  to  allay  the  pain  arising  from  the  near  expo- 
sure of  the  pulps  of  teeth ;  also  the  pain  of  sensitive  dentine, 
and  that  following  the  extraction  of  teeth  affected  with  peri- 
ostitis ;  also  to  arrest  the  hemorrhage  and  allay  the  pain  of 
wounded  pulps  of  teeth.  It  forms  an  efficient  anodyne  when 
in  the  form  of  a  strong  solution  of  camphor  in  chloroform. 
Camphor  has  also  been  employed  in  the  treatment  of  putrescent 
pulps  of  teeth. 

Combined  with  creasote  or  carbolic  acid,  camphor  is  thought 
to  have  the  power  of  modifying  the  escharotic  action  of  these 
agents.  For  such  a  purpose,  20  grains  of  camphor  are  com- 
bined with  I  ounce  of  the  creasote  or  carbolic  acid. 

The  Oil  of  Camphor — Oleum  Camphorcs — is  preferred  by 
some  to  answer  such  indications.  Camphor  also  forms  one  of 
the  ingredients  of  the  celluloid  base  for  artificial  teeth,  which 
is  composed  of  pyroxylin,  100  parts,  camphor,  40  parts,  oxide 
of  zinc,  2  parts,  and  vermillion,  0.6  part.  With  ether,  camphor 
is  also  used  as  a  local  anaesthetic,  A  cataplasm  of  camphor, 
morphia  and  flaxseed,  applied  to  the  cheek,  has  been  used  for 
the  relief  of  odontalgia, 

DENTAL  FORMULA. 
For  a  Local  Ancesthetic.  For  a  Stimulant  and  Anodyme  Lotion. 

R.     Pulv.  Camphorse ^vj  ]J.     Spiritus  Rosemarini gj 

^ther.  Sulph fgj,      M.  Camphorse 5J 

SiGNA. — Apply   to   the   gum  over  the  Saponis  Albje ^iv.      M. 

tooth  to  be  removed,  until  it  turns     SiGNA. — To  be  applied  as  a  lotion, 
white  or  becomes  blanched. 

For  a  Local  Ancesthetic. 

For  a  Local  Ancesthetic.  R ,     Camphors s  j 

R,     Chloral,  ^thervel  Chloroformi.  jij.       M.. 

Camphorse aa .^^ij  Signa. — Apply    with    a     camel's-hair 

Morphige  Sulph ^ss  brush, 

Chloroformi ^j.        M,  For  Neuralgia. 

SiGNA. — Apply  with  camel's-hair  brush,     R.     Camphorse, 

allow  to  dry  and  reapply  as  freely  as  Chlor.  Hydratis  Sa  equal  parts.  M. 

is  necessary  to  render  part  insensible     SiGNA. — Apply  as  a  lotion, 
to  pain. 

12 


170  DENTAL    MEDICINE. 


CAMPHORA  MONOBROMATA— MONOBROMATED 
CAMPHOR. 

Formula.     CioHigBrOa. 

Derivation.  Monobromated  Camphor  is  obtained  by  the 
action  of  bromine  on  camphor,  and  subsequent  purification 
with  animal  charcoal  and  repeated  crystallization.  It  is  a 
colorless,  crystalline  substance,  with  the  odor  of  camphor  and 
turpentine,  and  a  slightly  bitter  taste.  It  is  insoluble  in  water, 
but  soluble  in  alcohol  and  ether. 

Medical  Properties  and  Action.  %\.  produces  a  sedative  effect 
upon  the  circulatory  system,  and  especially  upon  the  cerebro- 
spinal nervous  system,  and  is  also  an  antispasmodic. 

Therapeutic  Uses.  Bromide  of  Camphor  is  employed  as  a 
sedative  and  antispasmodic,  in  affections  of  the  nervous  system, 
and  where  camphor  is  indicated,  as  in  asthma,  neuralgia,  hys- 
teria, delirium  tremens,  etc. 

Dose.  Of  Bromide  of  Camphor,  gr.  ij  to  gr.  x,  for  an  adult. 
Dental  Uses.  In  dental  practice,  the  Bromide  of  Camphor 
is  employed  as  a  sedative  in  convulsions  of  dentition,  neuralgia, 
etc.  For  children  suffering  from  the  convulsions  of  dentition, 
gr.  j  of  the  bromide  of  camphor  in  acacia  mucilage,  and 
administered  every  hour,  has  been  very  serviceable  in  arresting 
the  paroxysms. 

CAPSICUM— CAPSICUM. 
Cayenne  Pepper. 
Source.  Capsicum  is  obtained  from  the  tropics  of  both 
hemispheres,  being  the  fruit  of  capsicum  anuum,  and  of  other 
species  of  capsicum.  The  crimson  or  yellow  pods  are  dried 
and  ground  to  powder,  which  has  a  bright  red  color,  and  an 
aromatic  smell,  with  a  bitter,  acrid,  burning  taste.  Its  acrid, 
pungent  qualities  are  due  to  a  peculiar  substance  in  the  form 
of  a  thick,  yellowish-red  fluid,  called  capsicine. 

Medical  Properties  and  Action.  Capsicum  is  a  powerful 
stimulant,  producing,  when  small  doses  are  taken,  a  sensation 
of  warmth  in  the  stomach,  and  a  general  glow  over  the  body. 
It  promotes  the  digestive  process,  and  stimulates  the  circula- 


CAPSICUM — CAPSICUM.  171 

tion,  and  also  the  genito-urinary  organs.     In  excessive  doses, 
capsicum  is  an  irritant  poison. 

Therapeutic  Uses.  It  is  employed  in  certain  forms  of  dys- 
pepsia, flatulent  colic,  scarlet  fever,  yellow  fever,  delirium 
tremens,  opium  habit,  etc.,  etc.  Externally  or  locally  as  a 
gargle,  in  putrid  and  other  forms  of  sore  throat,  chronic  inflam- 
mation of  the  fauces,  hoarseness  due  to  a  relaxed  condition  of 
the  vocal  cords,  relaxed  uvula,  and  in  poisoning  by  opium, 
belladonna  and  aconite,  it  has  proved  useful  as  a  stimulant. 

Dose.  Of  powdered  capsicum,  gr.  v  to  gr.  x,  in  pill.  Of 
the  tincture  of  capsicum — Tinctura  Capsici  (capsicum  Sj,  to 
diluted  alcohol  Oij) — the  dose  is  n\^x  to  f5j.  Of  the  infusion 
— Infusum  Capsici  (capsicum  Sss  ;  boiling  water  Oj — the  dose 
is  f  Sss.     The  infusion  is  also  used  as  a  gargle. 

Dental  Uses.  In  dental  practice  the  tincture  of  capsicum  is  * 
serviceable  in  acute  dental  periostitis,  where  it  is  necessary  to 
hasten  suppuration  as  quickly  as  possible,  on  account  of  the 
increasing  severity  of  the  attack — a  solution  composed  of  gtt. 
XXV,  in  a  glass  of  warm  water,  of  which  a  mouthful  is  to  be 
retained  for  some  minutes. 

Tincture  of  capsicum  is  also  useful  in  chronic  dental  perios- 
titis, to  resolve  the  inflammatory  products.  It  is  also  used  to 
stimulate  the  gums  and  mucous  membrane  of  the  mouth  in 
chronic  inflammation  and  ulceration,  and  for  looseness  of  the 
teeth  as  a  result  of  salivation  ;  also  in  cases  of  turgidity  and 
puffiness  of  the  gums.  It  is  often  serviceable  in  chronic 
alveolar  abscess,  as  an  injection,  after  the  sac  has  been 
destroyed;  also  in  recession  of  the  gums  from  the  necks  of  the 
teeth,  for  the  purpose  of  stimulating  them.  A  few  drops  added 
to  a  solution  of  aromatic  sulphuric  acid  will  prove  serviceable 
in  caries  of  the  maxillary  bones  and  in  disease  of  the  antrum. 
An  efficacious  stimulant  gargle  may  be  made  of  the  tincture  of 
capsicum,  Sss,  to  rose  water,  Sviij. 


172  DENTAL    MEDICINE. 


CARBO  ANIMALIS   PURIFICATUS— PURIFIED 
ANIMAL  CHARCOAL. 

Source.  Animal  charcoal,  called  "  bone  black,"  is  obtained 
by  exposing  bones  to  a  red  heat,  protected  from  the  air.  It 
consists  of  charcoal,  phosphate  and  carbonate  of  lime. 

Purified  Animal  Charcoal — Carbo  Animalis  Purificatiis — 
is  obtained  by  digesting  bone  black  in  hydrochloric  acid  and 
water  at  a  moderate  heat,  when  it  is  dried  and  heated  to  red- 
ness in  a  covered  crucible. 

Properties  and  Action.  Animal  charcoal  is  an  absorbent,  and 
is  used  to  counteract  the  effects  of  poisonous  agents,  such  as 
the  alkaloids  and  acids. 

Dose.  Of  animal  charcoal  as  an  absorbent,  Sss,  to  neutralize 
the  effects  of  each  grain  of  such  agents  as  strychnia  and  morphia, 

CARBO-LIGNI— WOOD  CHARCOAL. 

Source.  Wood  charcoal  is  obtained  by  subjecting  soft  wood 
to  a  red  heat  with  but  a  limited  supply  of  air,  by  which  the 
water,  etc.,  are  removed,  allowing  the  carbon  to  remain. 
,1  Properties  and  Action.  Wood  charcoal  is  antiseptic  and  dis- 
infectant and  detergent,  and  is  very  serviceable  in  correcting  the 
fetor  of  discharges  and  arresting  the  progress  of  ulceration, 
especially  when  in  the  form  of  the  dry  powder,  or  mixed  with 
linseed  as  a  poultice. 

Therapeutic  Uses.  For  foul  and  gangrenous  ulcers,  gan- 
grene, phagedaena,  suppurating  surfaces,  cancerous  tumors, 
etc.,  etc. 

Dental  Uses.  The  powdered  charcoal  added  to  water,  in  the 
proportion  of  one  or  two  drachms  to  a  glass  of  water,  forms  an 
efficient  disinfectant  gargle  for  the  offensive  fetor  of  mercurial 
stomatitis  ;  also  useful  in  foul  and  gangrenous  ulcers  of  the 
mouth,  diseased  gums,  offensive  ulcerations,  offensive  fetor  of 
cancrum  oris,  etc.,  etc.  Nothwithstanding  its  detergent  prop- 
erties, injury  results  from  its  use  as  a  dentifrice,  on  account  of 
its  tendency  to  cause  recession  of  the  gums  from  the  necks  of 
the  teeth. 


CARVACROL CARVACROL.  173 

CARVACROL— CARVACROL. 

Source.     The  caraway  plant,  a  native  of  Europe. 

Derivation.  Carvacrol  is  a  product  of  the  essential  oil  of 
caraway,  which  is  obtained  from  the  seeds  of  the  plant. 
Caraway — cariim — seeds  are  of  a  light  yellow  color,  with  a 
pleasant  aromatic  smell,  and  a  sweetish,  warm,  spicy  taste. 
They  are  stomachic  and  carminative,  and  are  occasionally  used 
in  flatulent  colic,  as  a  corrective  of  other  medicines.  The  vola- 
tile oil  of  caraway  is  most  employed  in  doses  of  gtt.  j  to  gtt.  x, 
Carvacrol  is  obtained  by  treating  the  oil  of  caraway  with 
iodine,  and  washing  the  product  with  potassa,  when  it  is  mixed 
with  carvene,  which  is  one  of  the  liquid  oils  of  caraway.  Car- 
vacrol is  also  found  among  the  products  of  the  action  of  iodine 
on  camphor.  When  pure  it  is  a  colorless,  viscid  oil,  lighter 
than  water,  in  which  it  is  nearly  insoluble.  Its  odor  is  like 
that  of  creasote,  and  its  taste  is  persistent,  strong  and  acrid. 

Medical  Properties  and  Action.  Carvacrol  is  antiseptic,  car- 
minative, disinfectant  and  escharotic.  Combined,  it  forms  an 
efficient  gargle  in  inflammatory  conditions.  It  is  not  employed 
internally. 

Dental  Uses.  In  dental  practice,  Carvacrol  has  been  em- 
ployed as  a  substitute  for  creasote,  carbolic  acid,  and  glycerole 
of  thymol,  in  the  treatment  of  odontalgia,  sensitive  dentine, 
alveolar  abscess,  and  as  an  antiseptic  in  the  pulp  canals  of 
teeth ;  also,  as  a  gargle  in  inflamed  and  ulcerated  conditions 
of  the  mucous  membrane  of  the  mouth,  tonsillitis,  etc.  Com- 
bined with  water,  in  the  proportion  of  3  drops  to  the  ounce,  it 
forms  an  efficient  gargle  in  stomatitis,  tonsillitis,  etc.;  the 
strength  of  the  solution  may  be  increased,  when  a  more  pow- 
erful action  is  required.  It  is  also  employed  with  advantage 
in  sensitive  cavities  of  the  teeth,  in  operating  with  the  dental 
engine,  to  lessen  the  pain  from  friction  of  the  instrument.  As 
an  application  in  odontalgia,  from  an  exposed  and  irritable 
pulp,  it  affords  almost  instantaneous  relief  It  is  claimed  for 
Carvacrol,  that  it  is  not  so  liable  to  cause  inflammation  as 
creasote  ;  especially  when  it  is  applied  through  the  pulp  canals. 


174  DENTAL    MEDICINE. 


When  employed  to  obtund  the  sensitiveness  of  dentine,  it  is 
necessary  to  confine  it  in  the  cavity  of  the  tooth  for  a  few  days, 
by  means  of  a  temporary  fiUing  of  zinc  preparation,  as  it 
readily  dissolves  Hill's  Stopping  and  gutta  percha.  When  it 
is  used  in  the  form  of  an  injection  in  alveolar  abscess,  a  sharp, 
burning  sensation  is  experienced  as  soon  as  it  reaches  the  seat 
of  the  affection,  when  the  crown  cavity  of  the  tooth  should  be 
immediately  closed. 

In  patients  of  a  scrofulous  diathesis,  it  is  necessary  to  exer- 
cise care  in  the  use  of  carvacrol.  When  applied  to  cavities 
before  the  introduction  of  the  filling,  and  to  exposed  pulps,  it 
is  introduced  on  a  pellet  of  cotton. 

CHLORAL— CHLORAL. 
Chloral  Hydras — Hydrate  of  Chloral. 

Formula.     C2HCI3OH2O. 

Derivation.  Chloral  is  obtained  by  the  action  of  dry  chlorine 
gas  on  absolute  alcohol,  and  is  purified  by  sulphuric  acid  and 
a  small  quantity  of  lime ;  a  small  quantity  of  water  converts 
it  into  solid  crystalline  hydrate  of  chloral.  It  is  in  the  form  of 
a  snow-white,  crystalline  mass,  with  a  pungent  odor  and  taste, 
soluble  in  its  own  weight  of  distilled  water,  and  very  soluble 
in  alcohol.  When  heated,  it  fuses  and  evaporates,  leaving  no 
residue,  and  in  the  air  without  combustion. 

Medical  Properties  and  Action.  Hydrate  of  Chloral  is  hyp- 
notic and  anaesthetic,  possessing  more  of  the  former  and  less 
of  the  latter  property  than  chloroform,  and,  unlike  chloroform, 
after  its  administration  there  is  no  elimination  by  the  breath  or 
urine.  It  diffuses  into  the  blood  rapidly,  causing  an  abundant 
flow  of  saliva,  and  a  cooling  sensation  in  the  stomach,  followed 
by  warmth.  Very  large  quantities  cause  a  high  degree  of 
gastric  irritation,  nausea  and  vomiting.  Taken  in  moderate 
quantity,  it  stimulates  the  appetite,  and  produces  muscular 
relaxation.  It  is  uniformly  certain  in  its  action  as  an  hypnotic, 
has  no  depressing  influence,  and  does  not  cause  constipation. 
Administered  in  doses  of  gr,  x  to  gr.  xxx,  it  causes  uncon- 


CHLORAL CHLORAL,  175 


sciousness  to  pain,  and  a  profound  sleep,  lasting  over  several 
hours.  The  sleep  it  produces  is  quiet  and  gentle,  and  induced 
without  distress.  Liebreich  claims  to  have  produced  sleep 
which  lasted  from  five  to  fifteen  hours,  with  from  25  to  30 
grains  of  hydrate  of  chloral. 

The  habitual  use  of  chloral  leads  to  a  disorder  which  is 
somewhat  similar  to  the  "  opium  habit,"  although  it  may  not  be 
as  persistent.  When  there  is  present  no  susceptibility  to  its 
hypnotic  action,  it  is  liable  to  cause  headache,  and  in  some 
cases,  a  delirious  excitement.  Its  hypnotic  action  is  immediately 
preceded  by  a  stage  of  excitement,  generally  of  short  duration, 
which  is  followed  by  sudden  and  complete  sleep,  very  much 
like  natural  sleep,  calm,  dreamless  and  refreshing.  It  differs 
from  a  condition  of  narcotism  from  the  fact  that  the  patient 
can  be  easily  roused  to  partake  of  nourishment,  and  will  readily 
fall  asleep  again. 

There  are  no  unpleasant  after-effects  resulting  from  a  moder- 
ate dose  of  chloral,  differing  in  this  respect  from  morphia, 
which  often  causes  headache,  faintness,  giddiness,  nausea,  and 
constipation.  Chloral  is  not  capable  of  producing  insensibility 
to  pain,  unless  the  quantity  administered  is  sufficient  to  suspend 
the  functions  of  the  cerebrum. 

When  a  proper  dose  is  administered,  the  pupil  contracts 
slightly,  but  the  pulse  may  remain  unaltered  or  become  slower, 
and  the  respiration  unaffected.  When  an  improper  or  danger- 
ous dose  is  taken,  profound  narcotism  ensues,  the  respiration 
becomes  slower,  the  pulse  weak,  rapid  and  irregular,  sensibility 
is  lost,  all  reflex  movements  are  impossible,  and  complete  mus- 
cular relaxation  follows.  It  destroys  life  by  the  suspension  of 
the  functions  of  the  cerebrum,  and  by  paralysis  of  the  respira- 
tory centre,  and  of  the  cardiac  ganglia;  also  death  may  suddenly 
follow  by  paralysis  of  the  heart,  in  cases  of  fatty  degeneration, 
and  the  lower  lobes  of  the  brain  remain  unaffected.  The  para- 
lytic phenomena  caused  by  chloral  are  due  to  its  direct  action 
on  the  nervous  centres.  The  congestion  of  the  meninges  of 
the  brain  and  cord,  and  distention  of  the  right  cavities  of  the 
heart,   have  been   observed  after  poisoning  by  chloral.     The 


176  DENTAL   MEDICINE. 


antidote  in  cases  of  poisoning  is  strychnia,  and  the  same  treat- 
ment as  in  opium  poisoning. 

Therapeutic  Uses.  The  most  important  uses  of  chloral  are 
in  diseases  of  the  nervous  system,  such  as  delirium  tremens, 
insanity,  tetanus,  acute  mania,  neuralgia,  chorea,  whooping 
cough,  and  in  rheumatism,  cholera  morbus,  sea  sickness,  etc., 
etc.  Having  no  direct  pain-relieving  power,  except  by  suspend- 
ing the  functions  of  the  cerebrum  and  in  dangerous  doses, 
sleep  can  be  procured  and  pain  relieved  by  combining  the 
chloral  with  morphia,  when  it  is  very  effective. 

Dose.  Of  Hydrate  of  Chloral,  gr.  v  to  3j ;  but  it  must  be 
remembered  that  one-half  drachm  has  produced  poisonous 
symptoms.  Thirty  grains  of  hydrate  of  chloral  are  equal  in 
effect  to  gr.  j  of  opium.  For  adults,  if  short  intervals  of  sleep 
are  required,  from  gr.  xxv  to  gr.  xxx  will  answer ;  for  young 
children,  gr.  vij  is  the  dose  recommended.  Moderate  and  fre- 
quently repeated  doses  are  better  than  a  single  large  one. 

Dental  Uses.  In  dental  practice,  the  hydrate  of  chloral,  in 
the  form  of  from  gr.  ss  to  gr.  j,  is  applied  to  inflamed  pulps  for 
the  relief  of  odontalgia,  and  is  an  efficient  remedy ;  it  is  also 
employed  for  the  relief  of  neuralgia  of  the  fifth  pair  of  nerves  ; 
as  a  stimulant  and  deodorizing  application  to  foul  and  fetid 
indolent  ulcers ;  also  as  a  local  anaesthetic,  for  this  purpose 
being  combined  with  camphor  and  other  agents  (see  Aconite), 
(see  Camphor) ;  also  as  an  anodyne,  for  the  relief  of  the  pain 
of  dental  periostitis;  and  as  an  injection,  for  alveolar  abscesses. 
Although  it  is  employed  hypodermically,  yet  painful  phlegmons 
have  resulted  from  its  repeated  application. 
DENTAL  FORMULA. 
For  Foul  and  Fetid  Indolent  Ulcers.  For  Foul  and  Fetid  Indolent  Ulcers. 

R.     Chloral  Hydratis gr.  x  R.     Chloral  Hydratis ^ss 

Aquse  Destillatae fgj.       M.  Adipis .^j.        M. 

SiGNA. — To  be  applied  as  a  lotion.  Signa. — To  be  used  as  an  ointment. 

For  a  Local  Ancesthetic.  For  a  Hypnotic. 

R.     Chloral  Hydratis ,^  ij  R.     Chloral  Hydratis ^ij 

Pulveris  Camphorae Jij.       M.  Syrupi  Aurantii  Floris... giv 

Signa. — To  be  applied  as  an  obtunding  Syrupi  Tolutani ^iv 

mixture,  by  means  of  an  applicator.  Aquae  Destillatas ^  vj.      M. 

Signa. — Dose,  i^  part,  largely  diluted 


CHLORINIUM CHLORINE.  177 

For  Odontalgia — Pulpitis.  For  Neuralgia. 

Flagg.  R.     Chloral  Hydratis partes  3 

R.     Chloral  Hydratis 5  iij  Camphorse partemi.  M. 

AquiE  Destill f^j.      M.     SiGNA. — To  be  applied  over  seat  of  pain. 

SiGNA. — Apply  on  cotton. 

For  a  Local  Ancesthetic. 
R .     Chloral  Hydratis, 

Pulveris  Camphoras.aa-^ij 

Morphise  Sulph ^ss 

Chloroformi ^j.  M. 

SiGNA. — Apply  with  camel's-hair  brush  ; 
dry  rapidly,  and  reapply. 

CHLORINIUM— CHLORINE. 

Denvation.  Chlorine  is  a  greenish-colored  gas,  of  a  pene- 
trating and  suffocating  odor,  very  persistent  and  characteristic. 
It  is  soluble  in  water,  in  the  proportion  of  two  volumes  of  the  gas 
to  one  of  water,  and  is  a  supporter  of  combustion.  It  is  generated 
from  black  oxide  of  manganese,  hydrochloric  acid  and  water, 
is  an  active  irritant,  and,  when  breathed,  excites  cough,  a  sense 
of  suffocation  and  irritation  of  the  mucous  membrane  of  the 
nostrils  and  bronchial  tubes,  and,  when  considerable  quantities 
are  inhaled,  it  induces  spitting  of  blood,  violent  pains,  and 
sometimes  death.  It  is  a  deodorizer  and  disinfectant,  and  has 
been  used  to  destroy  disease  germs  and  offensive  effluvia. 

Chlorine  Water — Aqua  Chlori,  is  an  aqueous  solution  of 
chlorine,  formed  by  passing  the  gas  through  water.  It  is  a 
greenish-yellow  liquid,  with  an  astringent  taste,  and  the  suffo- 
cating odor  of  chlorine  gas.  It  should  be  kept  in  glass-stop- 
pered bottles,  in  a  cool  place,  and  protected  from  the  light. 

Tlierapeiitic  Uses.  Chlorine  Water  is  used  internally  in 
malignant  fevers,  such  as  scarlet  fever,  typhus,  and  in  diphtheria, 
aphthae,  gangrene,  syphilis,  diseases  of  the  liver,  skin  diseases, 
etc. ;  and  as  an  antidote  for  hydrocyanic  acid.  The  poisonous 
effects  of  chlorine  gas  may  be  prevented  by  ammoniacal  gas, 
and  albumen  is  the  antidote  for  chlorine  water,  given  freely,  in 
the  form  of  milk,  flour,  eggs,  etc. 

Dose.     Of  Chlorine  Water,  foj  to  f5iv,  diluted. 

Dental  Uses.    Chlorine  Water  is  employed  in  dental  practice. 


178  DENTAL   MEDICINE. 


as  a  local  application  in  gangrene  of  the  mouth  and  fauces, 
aphthae,  cancrum  oris,  and  fetor  of  the  breath.  Chlorine  gas  has 
been  employed  to  bleach  discolored  teeth,  care  being  taken 
that  it  reaches  no  other  part  than  the  cavity  of  the  tooth  under- 
going such  treatment,  which  may  be  accomplished  by  the 
application  of  a  large  rubber  dam,  such  as  is  used  in  the  opera- 
tion of  filling  teeth. 

DENTAL  FORMULA. 

For  Aphthce  and  Gangrene  of  the  Mouth.  For  Fetor  of  the  Breath  and  an  Anti- 

K  .     Aquae  Chlori ^ss  septic. 

Aquae  Destillatse ^iiiss  R.     Liquoris  Chlori ^iv 

Syrupi  Simp §  ss.      M.  Mellis ^iv 

SiGNA. — To  be   used    as   a   gargle    or  Aquas  Destillatae ^  x.       M, 

lotion.  SiGNA, — To  be  used  as  a  gargle. 

For  Aphtha:,  Stomatitis,  and  Cancrum  For  Mercurial  Stomatitis. 

Oris.  R.     Liquoris  Chlori part,  j 

R.     Liquoris  Chlori  Aquse  Destillatse...part.  viij.      M. 

Mellis aa ^ij.       M.  Signa. — To  be  used  as  a  gargle  for  cor- 

SlGNA. — To  be  applied  as  a  lotion.  reeling   the    fetor,    and    diminishing 

slightly  the  discharge. 

CHLOROFORMUM— CHLOROFORM. 

Formula.     CHCI3.     Sp.  gr.  1.480. 

Derivation.  Chloroform  is  obtained  by  the  distillation  of 
alcohol  with  chlorinated  lime.  The  form  for  medicinal  use 
[Chloroformum  Purificatiini)  is  purified  by  agitation  with  sul- 
phuric acid,  which  frees  the  crude  chloroform  from  such  dele- 
terious agents  as  chlorinated  pyrogenous  oil;  the  lighter  liquid 
is  then  separated,  and  carbonate  of  sodium,  previously  dissolved 
in  water,  is  added  to  it.  The  mixture  is  then  agitated,  the 
chloroform  separated  from  the  supernatant  layer,  alcohol  mixed 
with  it,  and  lime  in  coarse  powder  added.  It  is  a  colorless, 
volatile  liquid,  of  an  agreeable  ethereal  odor,  and  a  hot,  aro- 
matic, sweet  taste.  It  is  slightly  soluble  in  water,  and  dissolves 
very  readily  in  alcohol  and  ether  in  all  proportions.  The  boil- 
ing point  is  142°  F.  The  purest  form  of  chloroform  has  a 
specific  gravity  of  1.5022,  while  the  officinal  contains  a  little 
alcohol ;  it  is  a  terchloride  of  formyl.  The  purest  chloroform 
for  internal  use  is  obtained  from  the  hydrate  of  chloral.  The 
purity  of  chloroform  may  be  ascertained  by  agitating  it  with 


CHLOROFORMUM CHLOROFORM.  179 

the  binitro-sulphuret  of  iron,  which  shows  the  presence  of  al- 
cohol, by  the  production  of  a  brown  tint;  chlorinated  pyro- 
genous  oil  may  be  detected  and  removed  by  strong  sulphuric 
acid,  which  gives  the  solution  a  yellowish  or  reddish-brown 
color,  if  such  an  impurity  is  present. 

Medical  Properties  and  Action.  Chloroform,  when  inhaled, 
is  an  anaesthetic;  and,  when  administered  internally,  is  ano- 
dyne and  antispasmodic.  Its  effects  on  the  system  are  similar 
to  those  of  ether,  but  more  powerful  and  more  rapidly  pro- 
duced, and  it  requires  more  care  in  its  administration,  both  in- 
ternally and  by  inhalation  of  the  vapor.  Undiluted,  it  excites 
great  irritation  and  inflammation  of  the  mucous  membrane,  and 
the  vapor,  passing  through  the  fauces  in  quantity,  may  enter 
the  larynx  and  cause  great  heat,  inflammation  and  even  oedema. 
When  taken  internally  it  causes  a  feeling  of  warmth  in  the 
stomach,  followed  by  coldness,  similar  to  ether,  and  if  taken 
in  large  quantity,  undiluted,  it  acts  as  an  irritant  poison,  in- 
ducing violent  gastritis.  It  is  diffused  into  the  blood,  and 
affects  remote  parts.  It  increases  the  action  of  the  circulatory 
system,  producing  excitement  of  the  brain,  followed  by  a  deep, 
heavy  sleep;  and  in  poisonous  doses,  stupor  and  insensibility. 
The  first  effect  of  the  inhalation  of  the  vapor  of  chloroform,  is 
a  feeling  of  warmth  and  excitement  extending  to  the  extremi- 
ties, which  is  succeeded  by  noises  in  the  ears  and  a  vibratory 
thrilling  and  benumbing  sensation  throughout  the  body,  fol- 
lowed by  loss  of  feeling,  motion  and  consciousness,  with 
general  paralysis  of  the  respiratory  muscles,  stertorous  breath- 
ing, quick  pulse,  which  may  become  irregular  and  weak,  owing 
to  the  sedative  action  on  the  heart.  The  pupils,  at  first  con- 
tracted, become  dilated,  and  there  is  complete  relaxation  of 
the  muscular  system. 

[As  the  physiological  actions  and  mode  of  administration  of 
chloroform  and  ether  are  similar,  the  reader  is  referred  to  the 
article  on  Sulphuric  Ether.] 

Therapeutic  Uses.  Besides  its  use  as  a  general  anaesthetic 
agent,  chloroform  is  internally  administered  in  substance,  as 
an  anodyne  and  antispasmodic,  for  non-inflammatory  affections, 


180  DENTAL    MEDICINE. 


such  as  nausea  and  vomiting,  sea-sickness,  sick  headache, 
flatulent  colic,  intermittent  fevers,  and  in  cholera,  for  which  it 
is  very  efficient.  The  vapor  is  employed  for  the  relief  of  hay 
asthma,  whooping  cough,  spasmodic  asthma,  and  as  an  hypnotic 
in  delirium  tremens,  and  as  an  injection  and  lotion  in  neuralgia, 
and  as  a  counter-irritant  or  vesicant,  for  which  purposes  it  is 
applied  to  the  skin,  and  evaporation  prevented.  Great  care  is 
necessary  in  the  administration  of  chloroform  in  substance, 
as  fatal  effects  have  followed  such  use ;  1 5  drops  have  de- 
stroyed life.  Externally,  chloroform  is  employed  as  a  stimu- 
lating application  to  foul  and  indolent  ulcers 

Dose.  Of  Chloroform,  r\,]  to  v,  in  sweetened  water  or  mu- 
cilage.    Dose  of  Chloroform  for  Inhalation,  5j  to  5ij. 

Spirit  of  Chloroform — Spiritiis  Chloroformi — is  composed 
of  chloroform,  Sj;  diluted  alcohol,  Sij.  Dose  of  Spirit  of 
Chloroform,  oss  to  5j. 

Dental  Uses.  Chloroform  is  employed,  in  dental  practice,  as 
a  general  anaesthetic;  also  as  a  local  anaesthetic,  for  which 
purpose  it  is  generally  combined  with  other  agents;  as  an 
anodyne  and  antispasmodic,  either  locally  applied,  or  the  vapor 
inhaled,  as  in  the  treatment  of  convulsions  of  dentition,  for  which 
it  is  a  very  efficient  remedy. 

DENTAL  FORMULA. 

For  a  Local  AncBsthetic.  For  a  Local  Ancesthetic. 

Von  Bonhorst.  R  .     Chloroformi  purificati, 

R .     Chloroformi,  Tincturse  Aconiti, 

Athens  Sulph.,  Alcoholis aa f ^j 

Spiriti  Lavandulae,  Morphinae  Sulphat gr.  vj.    M, 

Pyrethri  (Fluid  Ext.)  aa  f.fj.     M.  Signa. — To  be   applied   to  gum  over 

SiGNA. — Apply  for  one  or  two  minutes  root  of  tooth  to  be  extracted. 
to  gum  over  root  of  tooth  to  be  ex- 
tracted. 

For  an  Anodyne  Application  in  Neu-  For  Neuralgic  Affections  of  the  Teeth. 

ralgia.  R.     Chloroformi f^ j  or  i 

R.     Chloroformi f^j  Aquae Oj.  M. 

Linimenti  Camphora2...f^  ij.      M.  Signa. — To  be  used  as  a  wash  or  gargle. 


Signa. — To  be  applied  over  seat  of 
pain,  and  covered  with  oiled  silk,  to 
prevent  evaporation. 


CINCHONA   FLAVA ^\'ELLOW    CINCHONA. 


181 


For  Neuralgic  Affections. 

R.     Chloroformi ^ij 

Camphorse ,^jss 

Olei  OlivBe §  ij.       M. 

SiGNA. — To  be  applied  as  a  liniment 
over  seat  of  pain. 

For  a  Local  AncBsthetic. 

R.     Chloroformi part,  xx 

Acidi  Acetici  (Cryst.)...part.  j.  M. 
SiGNA. — Apply  with  camel's-hair  brush, 
or  by  applicator. 

For  Odontalgia — Pulpitis. 

R.     Chloroformi ^  ij 

Alcoholis ^j 

^ther |ss 

Camphorse  (Pulv.) ^  ss 

Tinct.  Opii ^ss 

Oleum  Caryophilli ^j.        M. 

SiGNA. — Apply  on  cotton  wool  to  ex- 
posed pulp. 


For  Neuralgic  Affections. 
R .     Chloroformi, 

Spiriti  Ammonia, 
Tincturse  Aconiti..aa..f3ij 

Olei  Ricini ^ij 

Linimenti  Saponis f^^j.  M. 

Sign  A. — To  be  applied  as  a  liniment 
over  seat  of  pain. 

For  Earache  of  Dentition. 

R.     Chloroformi ^j 

Oleum  Olivee ^j.        M. 

Signa. — Pour  from  gtt.  x  to  xx  in  ear, 
and  close  orifice  with  cotton. 

For  Odofitalgia — Pulpitis. 

R .     Chloroformi, 

Tinct.  Aconite. ...aa..../3iij 

Tinct.  Capsici f^j 

Tinct.  Pyrethri, 

Oleum  Caryoph...aa...f§  ss 

Camphorse  (Pulv.) ^ss.      M. 

Signa. — Apply  on  cotton  wool. 


CINCHONA  FLAVA— YELLOW  CINCHONA. 
■   Calisaya  Bark,  Peruvian  Bark. 

Source.  Cinchona  is  the  bark  of  the  tree  cinchona  cahsaya, 
which  grows  on  the  western  coast  of  South  America,  especially 
of  Bolivia  and  Southern  Peru.  Different  varieties  are  named, 
according  to  their  color,  as  Cinchoiia  Flava,  yellow  cinchona ; 
Cinchona  Pallida,  pale  cinchona ;  Cinchona  Rubra,  red  cin- 
chona. The  medicinal  properties  of  these  barks  depend  upon 
the  alkaloids  they  contain  in  varying  proportions,  Quinina 
being  the  most  important. 

Medical  Properties  and  Action.  The  yellow  bark  has  a  much 
more  bitter  taste  than  the  others,  but  is  comparatively  free  from 
acidity.  It  is  brownish  yellow,  the  powder  being  of  an  orange 
color,  and  it  contains  more  of  the  alkaloid  quinine  than  the 
other  barks. 

Cinchona  is  tonic,  astringent  and  antiperiodic,  and  the 
different  varieties  owe  their  tonic  and  antiperiodic  properties  to 


182  DENTAL    MEDICINE. 


the  alkaloids  quinina,  cinchonina,  and  cinchonidma.  On  account 
of  the  large  quantity  of  the  powdered  barks  it  is  necessary  to 
take  in  order  to  obtain  the  full  effects,  and  which  cause,  in  some 
cases,  derangement  of  the  stomach,  vomiting,  headache  and 
constipation,  the  alkaloid  quinine,  in  the  form  of  sulphate  of 
quinina,  is  preferable. 

Sulphate  of  Quinina — QidnincE  Sulphas,  is  prepared  by 
boiling  the  yellow  bark  in  water  acidulated  with  hydrochloric 
acid,  by  which  the  alkaloid  is  separated  from  its  combination 
with  kinic  and  other  acids,  to  form  a  soluble  hydrochlorate. 
This  salt  is  decomposed,  and  the  quinine  is  precipitated  by  the 
addition  of  lime,  and  afterwards  washed  in  boiling  alcohol. 

Sulphate  of  quinine  is  in  the  form  of  colorless,  very  light 
and  silky  crystals,  and  is  readily  soluble  in  alcohol,  and  in 
water  acidulated  with  sulphuric  acid.  It  is  insoluble  in  ether, 
and  requires  740  parts  of  cold,  or  30  parts  of  boiling,  water 
to  entirely  dissolve  it. 

Cinchona  is  also  antiseptic,  as  the  powder  dusted  over 
unhealthy  wounds  will  arrest  putrefaction,  and  promote  healthy 
cicatrization.  Quinina  will  destroy  minute  organisms,  and 
preserve  substances  from  decomposition.  The  cinchona  alka- 
loids are  readily  diffused  into  the  blood,  and  when  hypodermi- 
cally  injected,  are  absorbed  by  the  blood.  Cinchona  and  its 
alkaloids  increase  the  action  of  the  heart  slightly,  but,  in  large 
doses,  quinine  depresses  the  heart's  action  and  enfeebles  the 
pulse.  As  quinine  accumulates  in  the  brain,  a  sense  of  fullness 
in  the  head,  a  tightness  and  constriction  about  the  forehead,  a 
ringing  in  the  ears  {tinnitus  auriuni),  giddiness  and  vertigo,  are 
experienced.  Deafness  also  occurs,  as  the  effect  of  consider- 
able doses,  and,  if  continued,  permanent  injury  may  result. 
Poisonous  doses  cause  intense  headache,  dilated  pupils,  deliri- 
um, coma,  and  convulsions. 

Peruvian  bark  and  its  alkaloids  are  the  most  reliable  tonics 
and  antiperiodics. 

Therapeutic  Uses.  Cinchona,  and  its  alkaloid  quinine,  are 
internally  employed  in  the  treatment  of  intermittent  fevers,  and 
also   other  fevers,  such  as  remittent,  typhus,  puerperal  and 


CINCHONA  FLAVA YELLOW  CINCHONA. 


183 


scarlet ;  in  influenza,  neuralgias  of  a  malarial  origin,  acute 
rheumatism,  phthisis,  advanced  stages  of  pneumonia  and  pleur- 
isy, erysipelas,  urticaria,  diseases  of  the  eye,  epilepsy,  gangrene 
and  mortification,  scurvy,  pyaemia,  malarial  dysentery,  passive 
hemorrhages,  and  as  an  anthelmintic,  etc.,  etc. 

Dose.  Of  powdered  Cinchona,  3j  to  oiij,  given  in  infusion 
of  liquorice ;  of  the  extract  of  cinchona,  gr.  j  to  gr.  x,  in 
pill ;  of  sulphate  of  quinine,  gr.  j  to  9j. 

Dental  Uses.  Cinchona  and  its  alkaloid  quinine  are  employed 
in  dental  practice,  in  the  treatment  of  neuralgia  of  the  fifth  pair 
of  nerves,  when  due  to  malaria,  in  from  five  to  ten  grain  doses 
of  quinine ;  in  aphthous  ulcerations,  in  one  or  two  grain  doses 
every  two  or  three  hours,  especially  when  there  is  great  debil- 
ity ;  and  in  cancrum  oris ;  also  in  the  form  of  gargles  and 
lotions,  in  gangrenous  ulcerations  of  the  mouth.  Cinchona  is 
also  employed  in  the  form  of  powder,  as  an  ingredient  of  certain 
dentifrices,  for  its  tonic  and  antiseptic  properties. 
DENTAL  FORMULA. 


Dentifrice. 

R.     Pulv.  Cinchonse  Flav...  giij 

Cretffi  Prep _^  iij 

Sacchari  Albi ^j 

Pulv.  Cinnamon ^j 

Pulv.  Saponis  Cas.  Albi.  5  ij 

Pulv.  Myrrhse ^j. 

Dentifrice. 

R.     Pulv.  Cinchonse  Flav...  R)  ss 

Cretse  Prep ib  ss 

Pulv.  Myrrhse ^^iv 

Pulv.  Radicis  Iridis ^iv. 


M. 


M. 


For  Ulceration  of  Gums. 

R.     Pulv.  Cinchonse ^ii 

Cupri  Sulph gr.  x 

Acacise  (Pulv.) ^j 

Mellis ^ij 

Aquae  Purse .1  iij-      M. 

SiGNA. — Apply  with  camel's-hair  brush 
to  ulcerated  surface  of  mucous  mem- 
brane. 


Dentifrice. 

R.     Pulv.  Cinchonse  Flav..._:^iv 
Pulv.  Saponis  Cas  Albi.  ^  iv 

Cretas  Prep ^ij 

Magnesise  Calc ^iij 

Otto  Rosse gtt.  viij 

Olei  Caryophilli gtt.  vj.  M. 

For  a  Wash  after  the  Extraction  of  Teeth. 

R.     Cinchonse  (Decoct.) fjij 

Aluminse ^ij 

Infus.  Rosse fsij-     M. 

SiGNA. — Use  as  a  gargle. 

For  Mercurial  Stomatitis. 
Garrettson. 

R.     Tinct.  Cinchonse ^^  ij 

Potassse  Chloratis ^^  ss 

Sodse  Bibor ^ij 

Aluminis  Pulv ^ij 

Potassse  Permanganatisgr.  xxv 

Aquse  Colonise ^j 

Tinct.  Myrrhse ^j 

Tinct.  Capsici ?j 

Tinct.  Kramerise ^j 

Aquse gviij     M. 

Signa. — Use  as  a  gargle. 


184  DENTAL    MEDICINE. 


CINNAMOMUM— CINNAMON. 
Cassia  Bark. 

Source.  The  best  variety  of  cinnamon  is  obtained  from 
Ceylon,  and  is  the  prepared  bark  of  a  tree  of  the  natural  order 
LauracecB. 

It  is  in  the  form  of  long,  cylindrical  pieces,  thin,  smooth, 
and  of  a  yellow-brown  color,  with  a  fragrant  odor,  and  a  warm, 
sweetish,  aromatic,  and  slightly  astringent  taste.  It  contains  a 
volatile  oil,  a  slight  amount  of  tannic  acid,  an  acid  peculiar  to 
itself,  cinnamic  acid,  mucilage,  lignen,  etc. 

Medical  Properties  and  Action.  Cinnamon  is  an  aromatic 
stimulant  and  astringent,  being  more  powerful  as  a  local  than 
as  a  general  stimulant.  Its  medicinal  virtues  principally  reside 
in  a  volatile  oil,  oleum  cinnamomi. 

TherapeiLtic  Uses.  Cinnamon  is  chiefly  used  as  an  adjunct  to 
other  medicines,  being  seldom  prescribed  alone,  though  it  is 
capable  of  allaying  nausea  and  vomiting,  and  also  relieving 
flatulence.  Combined  with  chalk  and  with  other  astringents, 
it  is  well  adapted  for  the  treatment  of  diarrhoea. 

Dose.  Of  Cinnamon,  gr.  x  to  5ss  of  the  powder ;  of  the 
tincture,  the  dose  is  f5j  to  fSiij. 

Oil  of  Cinnamon — Oleum  Cinnamomi,  is  obtained  by  distil- 
lation, and,  when  fresh,  is  of  a  light  yellow  color,  which 
becomes  deeper  by  age,  and  ultimately  red.  It  has  an  excess- 
ively hot,  pungent  taste.  It  is  often  employed  to  conceal  the 
taste  of  other  medicines,  and  is  a  powerful  local  stimulant. 
Large  doses  of  the  oil  of  cinnamon  are  poisonous,  producing 
an  inflamed  and  corroded  condition  of  the  gastric  and  intestinal 
mucous  membrane. 

Dose.  Of  the  Oil  of  Cinnamon,  gtt.  j  or  gtt.  ij,  administered 
in  the  form  of  an  emulsion. 

Cinnamon  Water — Aqua  Cinnamomi — (cinnamon,  carbonate 
of  magnesia,  and  distilled  water),  is  used  as  a  vehicle  for  other 
medicines. 

Spirit  of  Cinnamon — Spiritus  Cinnamomi — (oil  of  cinnamon, 
I  part,  stronger  alcohol,  1 5  parts).     Dose,  gtt.  x  to  gtt.  xx. 


COLLODIUM — COLLODION.  185 

Dental  Uses.  Cinnamon,  in  the  form  of  powder,  is  employed 
as  an  ingredient  of  dentifrices,  for  its  stimulant,  astringent  and 
aromatic  properties.  Oil  of  Cinnamon  is  employed  in  dental 
practice  for  the  relief  of  odontalgia.  One  drop  applied  to  an 
inflamed  dental  pulp  will  afford  temporary  relief. 

COLLODIUM— COLLODION. 

Derivation.  Collodion  is  a  solution  of  4  parts  of  pyroxylin 
in  70  parts  of  stronger  ether  and  26  parts  of  alcohol.  Pyroxy- 
lin, or  gun  cotton,  is  prepared  by  adding  a  mixture  of  nitric 
and  sulphuric  acids  to  cotton  freed  from  impurities. 

Collodion  is  a  colorless,  syrupy,  and  very  inflammable  liquid, 
with  a  strong  ethereal  odor.  By  long  standing  and  exposure, 
or  when  applied  to  a  surface,  it  deposits  a  thin,  transparent  and 
strongly  contractile  film,  which  is  insoluble  in  water  or  alcohol. 
It  should  be  kept  in  glass-stoppered  bottles.  It  is  applied  by 
means  of  a  camel-hair  brush.  When  it  becomes  too  thick,  it 
may  be  diluted  by  a  solution  constituted  of  ether,  3  parts, 
alcohol,  I  part. 

Medical  Properties  and  Action.  It  is  serviceable  as  an  emol- 
lient, and  its  action  is  mechanical,  as  it  draws  together  and 
holds  in  apposition  divided  parts,  and  protects  such,  as  well  as 
abraded  or  denuded  surfaces,  from  contact  with  the  air.  As  the 
ether  it  contains  evaporates,  the  surface  of  the  part  to  which  it 
is  applied  is  constringed,  and  a  degree  of  pressure  is  thus 
established,  which  is  very  useful  in  moderating  vascular  action, 
promoting  absorption,  and  changing  the  course  of  pus  which 
may  already  be  formed  into  a  direction  more  desirable.  On 
account  of  the  liability  of  collodion  to  crack  and  peel  off,  these 
objections  have  been  obviated  by  the  use  of  what  is  known  as 
Flexible  Collodion — Collodiimi  Flexile — (collodion,  92  parts, 
Canada  turpentine,  5  parts,  castor  oil,  3  parts),  which  is  softer 
and  more  pliable  and  elastic. 

Therapeutic  Uses.  Collodion  is  very  useful  in  ulcers,  fissures, 
incised  wounds,  abraded  surfaces,  erysipelas,  skin  diseases,  etc. 

Dental  Uses.  Collodion  is  a  very  useful  application  in  dental 
13 


186  DENTAL   MEDICINE. 


practice,  to  prevent  alveolar  abscesses  from  discharging  exter- 
nally on  the  face;  for  such  a  purpose,  it  is  applied  in  successive 
layers,  so  as  to  act  as  a  compress,  and,  by  moderating  the  vas- 
cular action,  cause  absorption,  or  such  a  change  in  the  direction 
of  the  discharge  as  will  induce  it  to  open  in  the  mouth.  It  is 
also  employed  in  combination  with  carbolic  acid,  as  an  appli- 
cation for  odontalgia ;  when  introduced  on  cotton,  it  acts  as  a 
temporary  filling ;  it  has  also  been  employed  for  arresting  the 
mucous  secretion  during  the  operation  of  filling  cavities  near  to 
or  under  the  margin  of  the  gum,  but  the  rubber  dam  has  super- 
seded its  use  in  this  respect.  Combined  with  iron  and  other 
agents,  it  forms  a  styptic  preparation. 

In  the  dental  laboratory,  collodion,  in  the  form  of  a  colored 
preparation,  is  employed  to  coat  the  surfaces  of  the  plaster 
models  of  plastic  work,  and  when  not  applied  too  thick,  it 
protects  the  plaster  surface,  and  also  prevents  an  unsightly 
rubber  surface  on  the  part  of  the  plate  which  is  adapted  to 
the  mucous  surface  of  the  mouth.  When  this  preparation 
becomes  too  thick  for  use,  it  may  be  diluted  with  a  solution  of 
3  parts  of  ether  to  i  part  of  alcohol. 

Cantharidal  Collodion — Collodiiun  cum  Cantharide,  is 
composed  of  cantharides  (Spanish  flies),  in  powder,  60  parts, 
flexile  collodion,  85  parts,  commercial  chloroform,  q.  s.  The 
addition  of  one  per  cent,  of  Venice  turpentine  to  cantharidal 
collodion  will  prevent  the  disagreeable,  and,  at  times,  painful 
contraction  of  the  preparation  on  drying. 

Like  cantharides,  cantharidal  collodion,  when  locally  applied, 
excites  inflammation  of  the  skin  and  mucous  membrane,  which 
terminates  in  a  copious  secretion  of  serum  under  the  cuticle. 
It  produces  a  blister  in  the  same  time  as  the  ordinary  blistering 
plaster,  and  is  applied  with  greater  facility,  and  is  better  adapted 
to  cover  uneven  surfaces,  and  retains  its  place  more  certainly. 
It  acts  much  more  readily  if  the  evaporation  of  the  ether  is 
restrained  by  a  piece  of  oiled  silk  placed  over  the  surface 
immediately  after  the  application  of  the  collodion. 

Dental  Uses.  Cantharidal  collodion  is  a  valuable  application 
in  dental  periostitis,  applied  to  the  gum  over  the  root  of  the 


CREASOTUM CREASOTE.  187 

affected  tooth,  by  means    of  a   camel-hair  brush,  previously 

removing  all  moisture  from  the  surface,  and  protecting  the  lips 

and  cheeks,  until  the  ether  it  contains  has  evaporated,  and  an 

artificial  cuticle  is  formed.    The  blister  which  rises  on  the  gum 

should  be  punctured  with  a  needle.    The  counter  irritation  thus 

produced  relieves  the  periosteal  inflammation. 

'   Iodized    Collodion — Collodium    lodidum — (collodion,   Sj, 

iodine,  gr.  xx),  forms  a  good  solution   of  iodine   for  external 

use, 

DENTAL  FORMULA. 

For  Odojttalgia.  For  a  Styptic. 

R.     Acidi  Carbolici  Cryst.,  R.     Collodii ^r^iij 

Collodii aa ^j.        M.  Tinct  Ferri  Perchloridi.;^] 

SiGNA. — To  be  applied  on  cotton.  Olei  Ricini gtt.  ij.    M. 

For  a  Styptic.  SiGNA. — To  be  applied  to  the  bleeding 

R.     Collodii partes  lOO  surface,  or,  on  cotton,  to  the  alveolar 

Acidi  Carbolici. ..partes     lo  cavity. 

Acidi  Tannici.... partes       5  For  a  Styptic. 

Acidi  Benzoici... partes      5.      M.  R.     Acidi  Tannici, 

SiGNA. — To  be  applied  to  the  bleeding  Alcoholis, 

surface   by   means    of  a   camel-hair  .^theris aa partes  sq.        M. 

brush.  Then  add  as  much  pyroxylin  as  the  solu- 
tion will  dissolve. 

CREASOTUM— CREASOTE. 

For7mda.     CgHioOg.     Sp.  gr.  1.07 1. 

Derivation.  Creasote  is  a  product  of  the  distillation  of  wood 
tar,  its  name  being  derived  from  the  Greek  XpsaZ^  "  flesh,"  and 
ou)Tr,i^  "  preserver,"  as  animal  substances,  when  saturated  with 
it,  are  preserved  from  putrefaction.  It  is  also  obtained  from 
crude  pyroligneous  acid. 

Creasote,  when  fresh  and  pure,  is  a  colorless,  oleaginous 
fluid,  with  a  strong,  empyreumatic  odor,  resembling  closely 
carbolic  acid,  and  a  caustic,  burning  taste.  After  exposure,  it 
has  a  yellowish  or  brownish  tinge.  Its  purity  may  be  tested 
by  strong  acetic  acid,  which  dissolves  the  creasote,  and  leaves 
behind  the  impurities  floating  above  the  creasote  solution.  It 
may  also  be  tested  by  dropping  it  on  paper,  when,  if  pure,  it 
will,  after  being  volatilized  by  heat,  leave  no  stain.  Creasote 
may  be    distinguished    from    carbolic    acid,  which    it    closely 


188  DENTAL    MEDICINE. 


resembles  in  many  respects,  by  not  coagulating  collodion 
when  mixed  with  it,  and  by  not  imparting  a  blue  color  to 
a  piece  of  pine  wood  dipped  first  into  an  alkaline  solution 
of  creasote,  and  then,  after  drying,  into  muriatic  acid. 

Medical  Properties  and  Action.  Creasote  is  stimulant, 
sedative,  rubefacient,  escharotic,  styptic  and  antiseptic.  It 
possesses  the  property  of  immediately  coagulating  albumen, 
and  to  this  property  is  ascribed  many  of  its  effects  on  the 
living  system.  In  large  doses  it  is  an  acro-narcotic  poison ; 
but  in  small  doses,  it  is  styptic  and  astringent,  and  for  the 
latter  property  it  is  more  generally  administered  than  for 
any  other.  When  creasote  comes  in  contact  with  the  blood, 
the  latter  changes  from  a  bright  red  to  a  reddish  brown 
color,  with  small  spots  of  coagulated  albumen,  and  also 
becomes  thicker.  Applied  to  the  tongue,  it  causes  severe 
pain,  but  without  redness  or  tumefaction ;  it  also  causes  a 
strong  taste  of  smoke,  and  a  copious  flow  of  saliva.  When 
administered  internally  in  small  doses,  it  causes  a  sensation  of 
warmth  in  the  stomach,  and  exercises  a  decided  sedative  action. 
In  large  and  poisonous  doses,  it  produces  profound  stupor, 
flushed  countenance,  fixed  eyes,  slow  and  labored  pulse,  irrit- 
able stomach,  nausea,  vertigo,  but  has  no  effect,  such  as  dila- 
tion or  contraction,  on  the  pupils.  The  treatment  in  cases  of 
poisoning  by  creasote  consists  in  administering  albumen,  such 
as  white  of  eggs,  milk,  or  wheat  flour ;  also  the  administration 
of  ammonia  and  other  stimulants,  mustard,  emetics,  etc.  Death 
from  creasote  is  caused  by  its  coagulating  the  albumen  of  the 
blood,  and  preventing  its  circulation  through  the  arterial  system. 

Therapeutic  Uses.  Creasote  is  administered  internally  for 
gastric  irritability  and  vomiting,  flatulence,  diarrhoea,  diabetes, 
haemoptysis,  pulmonary  consumption,  chronic  bronchitis,  epi- 
lepsy, neuralgia,  etc.  Externally,  it  is  applied  to  ulcers,  erup- 
tions, diseases  of  the  skin,  wounds,  hemorrhage  from  wounds 
or  leech  bites,  warts;  also  in  putrid  sore  throat,  as  a  gargle. 

Dose.  Of  Creasote,  gtt.  j  or  gtt.  ij,  several  times  a  day,  either 
in  mucilage,  in  the  proportion  of  half  a  fluid  ounce  to  a  drop 
of  the  creasote ;  or  it  may  be  given  in  pill  form.     For  external 


CREASOTUM CREASOTE.  189 

use,  from  gtt.  ij  to   gtt.  vj,  or  more,  may  be  added  to  a  fluid 
ounce  of  water. 

Creasote  Water — Agues  O'casoti — (creasote,  5j,  distilled 
water,  Oj).     Dose  of  creasote  water,  f5j  to  f.5iv. 

Dental  Uses.  Creasote,  like  carbolic  acid,  is  a  valuable  agent 
in  dental  practice,  although  the  use  of  the  latter  has,  in  some 
respects,  superseded  that  of  the  former,  the  two  being  very- 
similar  in  their  action,  with  some  advantages  in  the  case  of 
carbolic  acid.  Creasote  is  employed  for  the  relief  of  odontal- 
gia, obtunding  the  sensitiveness  of  dentine,  alveolar  abscess, 
dental  periostitis,  suppurating  pulps  of  teeth,  devitalizing  pulps 
of  teeth,  treatment  of  exposed  pulps  of  teeth,  mercurial  and 
other  forms  of  stomatitis,  ulcers  of  the  mouth,  diseases  of  the 
gums;  as  a  styptic  for  hemorrhage  from  the  gums,  mucous 
membrane  and  leech  bites,  and  after  the  extraction  of  teeth 
Creasote,  like  carbolic  acid,  has  a  peculiar  power  as  an  anti- 
septic, hence  it  is  a  valuable  application  in  cases  attended  with 
offensive  purulent  discharges.  It  promotes  the  growth  of 
healthy  granulations,  and  hastens  the  healing  of  wounds,  and 
arrests  the  process  of  suppuration.  When  applied  to  ulcerated 
surfaces,  it  should  be  repeated  as  pus  is  formed  or  fungous 
growths  appear.  It  is  a  painful  escharotic  upon  mucous  mem- 
brane, with,  however,  a  soothing  reaction.  An  ointment — 
Unguentuni  Creasoti — is  composed  of  creasote,  foss,  lard,  5j, 
and  is  useful  in  cutaneous  affections. 

For  the  treatment  of  exposed  pulps  it  is  employed  either 
diluted  or  in  its  full  strength  ;  for  dental  periostitis  and  alveolar 
abscess,  in  its  full  strength,  or  in  combination  with  such  agents 
as  glycerine,  iodine,  etc. ;  also  in  devitalized  teeth,  and  as  an  anti- 
septic application  in  ulceration  of  the  mouth,  and  recession  of 
gums  from  the  necks  of  the  teeth.  When  used  as  a  styptic  after 
the  extraction  of  teeth  it  is  applied  on  lint  or  cotton,  with  pres- 
sure; and  diluted  with  water,  it  is  employed  in  the  treatment 
of  caries  and  necrosis  of  the  maxillary  bones.  To  dilute  it  for 
injections  it  is  often  mixed  with  alcohol,  and  the  strength 
reduced  by  adding  water.  Mixed  with  an  equal  quantity  of 
oil  of  cloves  its  odor  and  taste  are  modified.     Creasote  is  also 


190  DENTAL   MEDICINE. 

employed  to  neutralize  any  acid  remaining  in  the  cavity  of  a 
tooth  about  to  be  filled,  and  to  harden  and  render  imperishable 
the  contents  of  the  dentinal  tubuli,  for  which  purpose  it  is 
applied  to  the  walls  of  the  cavity  on  a  pellet  of  cotton. 

DENTAL  FORMULA. 

For  Alveolar  Abscesses.  For  Odontalgia. 

R.     Creasoti,  R.     Creasoti, 

Linimenti  lodi,  partes  cequales.  M.  Chloroformi, 

SiGNA. — To  be  used  as  an  injection.  Liquidi  Opii aa ^iij 

Tinctura  Benzoini ^j.        M. 

For   Odontalgia.  SiGNA. — To  be  applied,  on  a  pellet  of 

R.     Creasoti ^ss  cotton,  to  carious  cavity. 

Camphorse gr.  x.     M. 

SiGNA. — To  be  applied,  on  a  pellet  of  For  Odontalgia. 

cotton,  to  carious  cavity.  R .     Creasoti, 

Chloroformi, 
For  Odontalgia.  Morphinse    Hydrochlo- 

R.     Creasoti ^ij  ratis aa ^iij 

Morphinse  Acetatis gr.  xx.  M.  Tincturae  Benzoini 3J.         M. 

SiGNA. — To  be    applied,  on  cotton,  to     Signa. — To  be  applied,  on  a  pellet  of 
carious  cavity.  cotton,  to  carious  cavity.    (See  Formu- 

Ise  of  Carbolic  Acid.) 

CRETA  PR^PARATA— PREPARED  CHALK. 
Precipitated  Chalk,  Carbonate  of  Lime. 

Formula,     CaCOj. 

Derivation.  Prepared  chalk  is  obtained  by  freeing  chalk 
from  such  impurities  as  gritty  and  flinty  substances  and  sol- 
uble saline  matter,  by  elutriation,  and  afterwards  drying  it. 
It  is  the  only  form  in  which  chalk  is  used  medicinally. 

Medical  Properties  ajid  Action.  Prepared  chalk  is  antacid, 
absorbent  and  astringent.  It  diminishes  the  secretion  of  the 
mucous  membrane,  and  at  the  same  time  acts  as  antacid  in 
correcting  any  acidity  present.  When  internally  administered 
for  a  considerable  time,  like  magnesia,  it  accumulates  in  the 
bowels  and  forms  intestinal  secretions ;  hence  an  occasional 
aperient  is  necessary. 

Therapeutic  Uses.  Prepared  chalk  is  an  excellent  antacid 
in  diarrhoea  from  acidity,  in  acidity  attending  dyspepsia  and 


CRETA    PRiEPARATA PREPARED    CHALK.  191 

gout,  chronic  bronchitis  in  advanced  stages,  rachitis,  etc. 
Externally,  it  is  employed  in  the  treatment  of  ulcers,  burns, 
excoriations  and  skin  diseases.  It  moderately  stimulates  ulcers 
and  absorbs  the  discharge,  thus  preventing  them  from  spread- 
ing. 

It  is  an  antidote  for  poisoning  by  oxalic  and  most  of  the 
vegetable  and  mineral  acids. 

Dose.  Of  Prepared  Chalk,  gr.  v  to  9j,  in  powder  or  sus- 
pended in  water  by  the  aid  of  mucilage  and  sugar. 

Chalk  Mixture — Mistura  CretcB — (prepared  chalk,  Sss  ; 
acacia,  gr.  cxx  ;  water,  fSiv,)  is  often  combined  with  opiates 
and  astringents,  such  as  laudanum  and  tincture  of  kino,  or  of 
catechu,  in  the  treatment  of  diarrhoea.     Dose,  5j  to  5ss. 

Dental  Uses.  Prepared  chalk  is  used  in  dental  practice 
chiefly  for  its  antacid  property,  and  generally  as  an  ingredient 
of  dentifrices  ;  it  is  also  employed  in  the  form  of  powder  as  an 
antacid  in  acidity  of  the  oral  fluids,  for  which  purpose  it  is 
rubbed  between  the  teeth  and  permitted  to  remain  during  the 
night ;  it  is  also  employed  to  obtund  the  sensitiveness  of 
dentine,  on  account  of  its  absorbent  and  antacid  properties  ; 
for  such  a  purpose  it  should  be  applied  repeatedly,  for  several 
days,  to  the  sensitive  surface.  In  the  dental  laboratory  it  is 
used  as  a  polishing  powder  for  metal  and  plastic  work ;  also 
for  polishing  the  surfaces  of  gold  fillings.  The  precipitated 
chalk  of  the  Pharmacopoeia  is  the  preparation  to  be  preferred, 
on  account  of  its  freedom  from  gritty  particles. 

DENTAL  FORMULA. 

Dentifrice.  Dentifrice. 

(Chapin  A.  Harris.)  R.     Pulv.  Radicis  Iridis ibss 

R.     Cretffi  Praeparatse f^'w  Cretse  Prseparatas ^iv 

Pulv.  Radicis  Iridis ^iv  Sodii  Carb ^ss 

Pulv.  Cinnamon ^iv  Pulv.  Cinchonse ^iv 

Sodii    Carbonatis    Ex-  Pulv.  Sacchari  Albi....^  ij 

sicatae ^ss  Pulv.  Myrrhse ^j 

Pulv.  Sacchari  Albi ^j  Pulv.  Ossis  Sepise ^  ij 

Olei  Limonis gtt.  xv  Otto  Rosae gtt.  iv. 

Olei  Rosae gtt.  ij.  With  Rose  Pink,  q.  s.  to  color. 

SiGNA. — Ingredients    to    be   thoroughly 
pulverized  and  well  mixed. 


192 


DENTAL    MEDICINE. 


R. 


R. 


Dentifrice. 
(Am.  Dent.  Association.) 

Crette  Praeparatae Ubiij 

Pulv.  Cinchonse Jbj 

Pulv.  Radicis  Iridis Ibj 

Pulv.  Sacchari  Albi Ibjss 

Pulv.  Saponis  Cas §j 

Sodii  Carb ^  j 

Olei  Sassafras gtt.  Ixxx. 

Dentifi'ice. 

Cretse  Prsep ^iij 

Pulv.  Radicis  Iridis ^  i j 

Pulv.  Sacchari  Albi 1^] 

Pulv.  Cinnamom ^iij 

Pulv.  Saponis  Cas 'T^x] 

Pulv.  Myrrhae gj 

01.  Gaultheriae gtt.  x.    M. 

Dentifrice  in  thefor??i  of  a  Camphorated 

Paste. 

(Keller  Medicine  Co.) 

PTS.  BY  WT. 

R.     Magnes.  Carb 2 

Glycerini i 

Potas  Chlorat 3 

Tr.  Camphoi-a i 

01.  Gaultherige q.  s. 

CretK  Praep q.  s. 

To  make  desired  number  of  parts. 

Syr.  Simplic q.  s.       M. 

To  make  a  thick  paste. 

Dentifrice  in  the  form  of  a  Paste  for 

Comp7'essible  Tubes. 

(Keller  Medicine  Co.) 

PTS.BYWT. 

Magnes.  Carbonat 2 

Sodii  Bicarb 3 

Potas.  Chlorat 5 

Calcii  Carbonat 20 


R 


Dentifrice. 
(Am.  Dent.  Association.) 

R.     Cretse  Prsep Ibiij 

Pulv.  Cinchonse Ibj 

Pulv.  Radicis  Iridis ftj 

Pulv.  Sacchari  Albi Ibjss 

Pulv.  Saponis  Cas gj 

Sodii  Carb ^j 

Glycerini if^  iij 

Mellis q.  s.      M. 

and  form  into  a  paste. 
Dentifrice,  Antacid,  Tonic   and  Anti- 
septic. 

R.     Cretse  Prasparatse 3  iv 

Quininse  Disulph gr.  iv 

Pulv.  Ossis  Sepiae ^iv 

Otto  Rosse gtt.  iv.  M. 

Dentifrice   in   the  form    of  Glycerine 

Tablets. 

(Keller  Medicine  Co.) 

PTS.  BYWT. 

R .     Solut.  Magnes.  Carb 2 

"      Sodii  Bicarb i 

"      Potas.  Chlorat.... 3 
"      Sapo.  Cas.  Albi..6 

Glycerini i 

Cal.  Carb 10 

01.  Gaultheria 

Cassise aa q.  s.        M. 

To  flavor. 
Dentifrice. 

R.     Cretse  Prseparatse R)iss 

Pulv.  Sodii  Boratis, 
Pulv.  Radicis  Iridis.aa.ftss 

Semen  Cardamom ^  j 

Pulv.  Sacchari  Albi...lbss 

Otto  Rosse q.  s.     M. 

To  flavor. 


Pulv. 


Sapo.  Cas. 

Glycerini 

Olei  Gaultherise, 

Olei  Limonis aa-. 

Syr.  Simplic 

SiGNA. — To  make  a  paste. 

Dentifrices  may  be  pleasantly  flavored  with  wintergreen, 
cassia,  sassafras,  lemon,  peppermint,  anise,  lavender,  penny- 
royal, cloves,  calamus,  attar  of  roses,  oil  of  neroli,  etc. 


.q.  S. 
.q.  S. 


CROTON-CHLORAL    HYDRATE.  193 

CROTON-CHLORAL  HYDRATE. 
Butyl-Chloral  Hydrate. 

Formula.     C4H5CI3OH2O. 

Derivation.  Croton-chloral  Hydrate  is  obtained  by  the 
action  of  chlorine  upon  aldehyde.  It  is  in  the  form  of  small, 
brilliant,  white,  silvery  crystals,  of  a  sweetish  taste,  like  that  of 
melons.  It  is  slightly  soluble  in  water,  and  resembles  hydrate 
of  chloral  in  its  hypnotic  effects ;  but  its  action  in  this  respect 
is  not  so  powerful,  nor  so  certain.  It  differs  from  hydrate  of 
chloral  in  the  singular  property  of  causing  anaesthesia  of  the 
head.  To  relieve  pain  and  induce  sleep,  the  best  effects  are 
obtained  from  a  combination  of  the  two  agents. 

Medical  Properties  and  Action.  It  is  sedative,  hypnotic  and 
anaesthetic.  It  resembles  chloral  hydrate,  but  is  not  so  certain 
in  its  effects  as  a  hypnotic.  Its  action  commences  in  the  head 
and  face. 

Therapeutic  Uses.  Croton-chloral  hydrate  is  highly  recom- 
mended in  dysmenorrhoea,  sciatica,  chronic  cough,  and  in 
neuralgia  as  an  anodyne.  One  or  two  grains  will  relieve  severe 
neuralgia  of  the  fifth  pair  of  nerves  ;  it  is  frequently  necessary, 
however,  to  administer  from  five  to  fifteen  grains,  but  it  is  not 
safe  to  exceed  this  amount  at  one  time. 

Dose.  Of  Croton-chloral  Hydrate,  gr.  j  to  gr.  x;  as  an 
anaesthetic,  gr.  xv,  dissolved  in  warm  water. 

Dental  Uses.  It  is  employed  with  effect  in  facial  neuralgia, 
in  doses  of  from  two  to  five  grains  every  hour  or  two,  until 
fifteen  grains  have  been  taken ;  also,  as  a  sedative,  in  doses  of 
from  three  to  five  grains,  in  dental  periostitis,  pulpitis,  etc.,  etc. 

DENTAL  FORMULA. 
For  Neuralgic  Odoizialgia. 
Von  Kirchbauer. 

R.     Croton  Chloral ^j 

Glycerini 3  vj 

Aquae  Destill ^iiss 

Syr.  Aurantii ^iv 

Oleum  Foeniculse g't-^j.  M. 

SiGNA. — A  tablespoonful,  and,  if  pain 
continues  severe,  repeat  the  dose  in  an 
hour. 


194  DENTAL    MEDICINE. 


CUPRI  SULPHAS— SULPHATE  OF  COPPER. 
Blue  Vitriol,  Blue  Stone. 

Formula.     CUSO4,  5H2O. 

Derivation.  Sulphate  of  Copper  is  obtained  by  roasting  the 
native  sulphuret,  or  by  the  combination  of  oxide  of  copper  and 
sulphuric  acid,  filtering  and  crystallizing.  It  is  in  the  form  of 
blue  prismatic  crystals  which,  after  exposure  to  the  air, 
effloresce  to  a  slight  degree,  and  become  covered  with  a 
greenish-white  powder.     It  has  an  astringent,  metallic  taste. 

Medical  Properties  and  Action.  Sulphate  of  copper  is 
emetic,  tonic,  nervine,  stimulant,  and  astringent,  and  is  quite 
soluble  in  water,  but  insoluble  in  alcohol.  It  is  a  prompt  and 
efficient  emetic,  the  emesis  commencing  in  a  few  minutes  after 
it  reaches  the  stomach,  and  the  copper  comes  up  with  the 
vomited  matter.  Little  or  no  depression  follows  its  adminis- 
tration as  an  emetic,  and  it  is  especially  adapted  to  cases  of 
narcotic  poisoning. 

Therapeutic  Uses.  Sulphate  of  copper  is  employed  as  a 
prompt  and  efficient  emetic  in  cases  of  poisoning ;  it  is  also 
administered  in  intermittent  fever,  neuralgia,  diarrhoea,  dysen- 
tery, croup,  epilepsy,  hysteria,  etc.,  etc.  Externally  it  is 
applied  in  ulcerative  and  gangrenous  affections,  superficial 
hemorrhage,  leucorrhoea,  gonorrhoea,  ringworm,  purulent 
ophthalmia,  mucous  discharges,  diseases  of  the  skin,  indolent 
ulcers,  fungous  granulations,  warts,  etc. 

Dose.  Of  Sulphate  of  Copper  as  an  emetic,  gr.  iij  to  gr.  v ; 
or  dissolve  20  grains  in  two  ounces  of  distilled  water  and  give 
a  tablespoonful  every  15  minutes  until  vomiting  occurs.  For 
internal  use  other  than  emetic  the  dose  is  gr.  ^  to  gr.  ss,  in  pill. 

Dental  Uses.  Sulphate  of  copper  is  employed  in  dental 
practice,  in  the  form  of  the  ammoniacal  solution,  for  long 
standing  cases  of  neuralgia;  and  externally  it  is  applied  to 
ulcers  of  the  mouth,  cancrum  oris,  aphthous  ulceration, 
ulceration  of  the  gums  and  mucous  membrane  of  the  mouth, 
hemorrhage  from  leech  bites,  fungous  growths  of  the  gums, 
etc.,  etc. 


BICHLORIDE    OF    ETHIDENE.  195 

DENTAL  FORMULA. 

For  Cancrum    Oris,  AphlhiE  and  Can-  For  Gangrenous   Ulcers  of  the  Mouth 

grenous  Affections  of  the  Mouth.  and  Cancrum  Oris. 

R.     Cupri    Sulph.       (Povv-  R.     Cupri  Sulph ^ij 

dered) gr.  v  Pulv.  Cinchonte ^ss 

Mellis ^ss       M.  Aquse giv.      M. 

SiGNA. — Apply  as  a  lotion,  or  by  means  Signa. — Brush   over  ulcerated  surface 

of  a  camel's-hair  brush.  twice  daily. 

For  Ulcerative  Stomatitis.  For  Caries  of  the  Maxillary  Bones. 

R.     Cupri  Sulph gr.  x  (Bartholow.) 

Pulv.  Cinchona ^ij  R.     Cupri  Sulph 

Pulv.  Gum  Acacise ^^j  Zinci  Chloridi aa partes  xv 

Mellis -^ij  Liquor  Plumbi "       xxx 

Aqu«  5iij.      M.  Aceti  Destillatse "      cc. 

Signa. — Apply,  by  means  of  a  camel's-  Signa. — To  be  applied  for  30  minutes 

hair  brush,  to  the  ulcerated  surface.  at  a  time. 


ETHIDENE  DICHLORIDUM— BICHLORIDE  OF 
ETHIDENE. 

Formula.     C2H4CI2.     Sp.  gr.  1.225. 

Derivation.  Dichloride  of  Ethidene  is  obtained  in  the  prepa- 
ration of  chloral,  from  the  waste  products,  and  is  very  much 
like  chloroform  in  appearance,  odor  and  taste.  It  has  a 
variable  boiling  point  of  about  115°  F.,  and  is  readily  soluble 
in  alcohol,  sparingly  soluble  in  water,  and  but  slightly  soluble 
in  chloroform.     It  is  inflammable,  but  less  so  than  alcohol. 

Medical  Properties  and  Action.  Dichloride  of  ethidene  is  a 
general  anaesthetic,  and  is  said  to  occupy  an  intermediate  rank 
between  chloroform  and  ether.  It  reduces  the  action  of  the 
heart  to  a  less  degree  than  chloroform,  with,  however,  consid- 
erable depression  of  the  pulse. 

It  has  been  somewhat  employed  in  England,  where  it  is 
regarded  as  being  safer  than  chloroform  for  inhalation,  and 
requiring  a  less  quantity  to  produce  anaesthesia  than  ether. 

Methods  of  Administration.  It  is  recommended  to  admin- 
ter  nitrous  oxide  until  the  patient  is  nearly  unconscious,  and 
then  to  add  the  vapor  of  ethidene.  The  effects  of  this  agent 
are  described  as  follows :  The  pupils  dilate,  and  at  the  same 
time   stertorous   breathing  commences ;    the  pulse  falls,  and 


196  DENTAL    MEDICINE. 


should  be  carefully  watched,  and  insensibility  to  pain  con- 
tinues for  some  time  after  the  patient  becomes  conscious.  It 
is  also  claimed  for  this  agent  that  there  are  no  unpleasant 
after-effects,  the  patient  recovering  as  if  from  a  natural  sleep, 
with  a  clear  mind  and  distinct  utterance.  It  is  also  recom- 
mended to  combine  the  vapor  of  ethidene  with  that  of  nitrous 
oxide,  by  loosely  inserting  a  sponge  containing  half  an  ounce 
of  ethidene  in  the  nitrous  oxide  gas  inhaling  tube,  or  in  the 
rubber  supply  bag,  when  the  effect  is  said  to  be  more  profound 
and  agreeable  than  when  nitrotis  oxide  alone  is  administered, 
with  no  nausea  and  but  little  lividity  of  lips.  It  is  also  said  to 
produce  relaxation  of  the  muscles  rather  than  rigidity,  differing 
in  this  respect  from  nitrous  oxide  gas. 

Bichloride  of  ethidene  is  also  employed  as  a  local  anaes- 
thetic, in  the  same  manner  as  chloroform,  aconite,  etc.,  for  the 
relief  of  facial  neuralgia,  etc. 

It  has  not  been  introduced  to  any  extent  into  this  country. 

ETHYL  BROMIDUM— BROMIDE   OF   ETHYL. 
Hydrobromic  Ether. 

Formula.     C2H5Br.     Sp.  gr.  1.420. 

Derivation.  Bromide  of  Ethyl  is  obtained  from  bromide  of 
potassium,  sulphuric  acid,  alcohol  and  water,  by  distillation, 
and  re-distilled  by  chloride  of  calcium.  It  is  a  colorless  and  very 
volatile  liquid,  boiling  at  40°  C,  heavier  than  water,  and  pos- 
sesses an  agreeable  ethereal  odor  and  a  pungent  taste,  strong 
and  sweetish,  with  a  somewhat  burning  after-taste.  It  is  readily 
soluble  in  alcohol  and  ether,  and  but  sparingly  soluble  in 
water. 

Medical  Properties  and  Action.  Bromide  of  ethyl  is  con- 
sidered to  be  a  very  effective  and  pleasant  general  anaesthetic, 
but  like  all  other  agents  of  this  class,  it  must  be  administered 
with  great  care,  and  a  pure  article  employed.  There  is  no 
doubt  but  that  it  is  pleasanter  to  inhale  than  chloroform, 
exceedingly  rapid  in  producing  complete  unconsciousness,  and 
very  evanescent  in  its  action.     That  it  is  any  safer  than  some 


ETHYL  BROMIDUM BROMIDE  OF  ETHYL.        197 

other  and  older  agents  of  this  class,  clinical  experience  has 
not  demonstrated,  as  several  deaths  occurred  in  a  very  limited 
number  of  the  administrations  attending  its  introduction. 
Bromide  of  ethyl  is  not  inflammable,  nor  caustic,  nor  even 
irritant,  in  this  respect  being  preferable  to  chloroform,  which 
is  very  caustic,  and  to  sulphuric  ether,  of  which  the  ingestion 
is  nearly  impossible.  Dr.  Isaac  Ott,  comparing  bromide  of 
ethyl  with  other  anaesthetics,  says :  "  {a)  Chloroform  increases 
the  pulse,  then  slows  it  by  a  cardiac  inhibitory  stimulation ; 
ether  increases  the  pulse ;  nitrous  oxide  also  increases  it  by 
paralysis  of  cardiac  inhibitory  apparatus ;  whilst  bromide  of 
ethyl  increases  the  pulse  by  an  action  on  the  heart  itself  [b) 
Chloroform  reduces  the  blood  pressure  by  paralysis  of  the 
main  vasomoter  centre,  and  cardiac  debility;  ether  greatly 
increases  it  and  keeps  it  increased ;  and  nitrous  oxide  also 
increases  it ;  bromide  of  ethyl  increases  it  either  by  a  stimula- 
tion of  the  spinal  or  peripheral  vasomotor  system,  {c)  Chloro- 
form increases,  and  then  decreases,  respiration ;  nitrous  oxide 
reduces  it ;  bromide  of  ethyl  decreases  it  by  a  central  action." 
He  also  draws  the  following  conclusions:  "  i.  Bromide  of 
ethyl,  either  by  inhalation  or  subcutaneous  use,  kills,  by  a 
toxic  action  on  the  centres  of  respiration.  2.  That  the  decrease 
of  force  and  frequency  of  the  heart  contributes  to  the  paralysis 
of  the  respiratory  centres.  3.  That  injections  of  ethyl  into 
the  jugular,  toward  the  heart,  kill,  by  cardiac  arrest,  probably 
due  to  an  action  on  the  cardiac  muscle.  4.  Bromide  of  ethyl, 
in  toxic  doses,  depresses  momentarily  the  frequency  of  the 
heart,  which  is  followed  by  a  subsequent  rise  to  normal  rate. 
5.  Bromide  of  ethyl,  in  toxic  doses,  depresses  the  arterial 
tension,  due,  in  major  part,  to  the  depressant  action  of  the 
drug  upon  the  heart,  and  in  minor  part,  to  a  partial  loss  of  tone 
of  either  the  spinal  vasomotor  centres  or  the  peripheral  vaso- 
motor system.  6.  The  inhibitory  power  of  the  pneumogastric 
is  not  paralyzed." 

Introduced  into  the  stomach,  bromide  of  ethyl  does  not 
produce  anaesthesia,  as  when  absorbed  by  the  respiratory  organs, 
and  does  not  increase  the  pulse  over  its  normal  beat ;  and  in 


198  DENTAL   MEDICINE. 


the  second  stage,  causes  an  intermission  of  the  pulse  every 
second  beat. 

Administration.  Bromide  of  ethyl  is  best  administered  in  a 
folded  starched  napkin,  so  as  to  cover  the  face,  and  having 
inside  of  it  a  soft  linen  handkerchief  On  the  linen  handker- 
chief two  measured  drachms  of  the  agent  should  be  poured, 
and  the  patient  directed  to  take  long,  deep  inspirations,  or  what 
is  better,  to  make  prolonged  and  forced  expirations.  In  two 
minutes  from  the  time  of  administration  of  the  first  two 
drachms,  a  third  drachm  should  be  given,  and  this  should  be 
repeated  at  intervals  of  two  minutes.  Like  all  general  anses- 
thetics,  however,  the  quantity  for  inhalation  differs  according 
to  the  susceptibility  of  the  patient.  Two  drachms  of  the  bro- 
mide of  ethyl  will  generally,  in  from  one  to  three  minutes, 
produce  anaesthesia  as  profound  as  that  produced  by  an  ounce 
of  sulphuric  ether.  As  it  produces  an  anaesthetic  effect  on  the 
muscles  of  the  throat  and  upper  parts  of  the  pharynx,  it  is 
useful  for  operations  on  the  mouth  and  throat. 

Its  odor  is  more  rapidly  removed,  and  is  more  agreeable 
than  that  of  sulphuric  ether,  and  its  effects  more  rapid  than 
even  those  of  chloroform,  as  it  is  eliminated  by  respiration, 
and  by  the  kidneys,  more  speedily  than  any  other  general 
anaesthetic  agent.  It  requires  excessive  quantities  to  affect  the 
heart  and  respiration  to  any  great  degree.  Having  no  caustic 
action,  it  can  be  safely  applied  subcutaneously,  and  also  to  the 
external  auditory  meatus  and  to  the  mucous  membrane.  It 
evaporates  upon  the  skin  very  rapidly,  producing  a  very  sensible 
feeling  of  cold.  As  a  rule,  its  general  effects  are  as  follows  : 
Moderate  acceleration  of  the  pulse  and  respiration ;  slight 
excitement  or  talking,  and  seldom  any  struggling ;  flushing  of 
face ;  dilatation,  sometimes  preceded  by  contraction  of  pupil ; 
diaphoresis,  generally  profuse ;  complete  anaesthesia  in  two  or 
three  minutes ;  recovery  of  consciousness  in  from  one  to  two 
minutes  after  the  withdrawal  of  the  anaesthetic  agent;  no  after- 
vomiting. 

Any  specimen  of  bromide  of  ethyl  which  has  a  disagreeable 
odor,  or  which,  on  standing,  becomes  brown,  or  any  that  will 


EUCALYPTUS EUCALYPTUS.  199 


explode  and  burn,  is  impure,  and  should  not  be  employed  for 
inhalation.  A  common  impurity  is  bromoform,  produced  by 
the  action  of  bromine  and  caustic  potassa  on  alcohol,  or  wood 
spirit.  Bromide  of  ethyl  possesses  properties  intermediate 
between  those  of  chloroform  and  ether.  As  a  local  anaesthetic, 
it  is  highly  spoken  of,  and,  owing  to  its  non-inflammability,  is 
the  only  anaesthetic  which  can  be  used  in  connection  with  the 
actual  cautery  For  use  as  a  local  anaesthetic,  the  bromide  of 
ethyl  is  atomized  with  the  "  spray  apparatus,"  which  should 
furnish  enough  of  the  liquid  to  moisten  the  skin.  The  extrem- 
ity of  the  tube  should  be  held  some  two  or  three  inches  from 
the  surface  on  which  the  spray  is  to  be  thrown.  Within  two 
or  three  minutes  after  its  first  application,  anaesthesia  of  the 
part  occurs,  which  is  shown  by  the  appearance  of  a  white  spot. 
The  formation  of  this  spot  may  be  hastened  by  superficially 
puncturing  or  scratching  the  skin.  The  sensation  of  cold  thus 
produced  is  sometimes  disagreeable,  but  is  rarely  painful.  The 
skin,  and  even  a  thin  layer  of  the  subjacent  tissue,  may  be 
painlessly  incised  while  the  white  spot  lasts.  This  anaesthetic 
appears  to  be  very  well  adapted  for  short  operations,  requiring 
simple  anaesthesia  and  not  complete  muscular  resolution,  hence 
it  is  now  preferred  by  some,  for  the  extraction  of  teeth,  to 
either  chloroform  or  ether.  Internally,  bromide  of  ethyl  has 
lately  been  recommended  for  whooping  cough,  in  the  form  of 
a  solution  of  i  part  of  bromide  of  ethyl  in  200  parts  of  water ; 
also  in  angina  pectoris,  the  dose  being  one-half  to  two  ounces. 
Given  internally,  it  is  also  said  to  relieve  gastric  pain,  without 
affecting  the  appetite.  Inhalations  readily  relieve  convulsive 
cough ;  and,  introduced  on  cotton  wool  into  the  external 
meatus,  it  relieves   the  pain  of  otalgia,  without   causing   any 


irritation. 


EUCALYPTUS— EUCALYPTUS. 


Source.  Eucalyptus  is  obtained  from  the  eucalyptus  globulus, 
a  tree  of  large  size,  and  of  the  natural  order  Myrtaceae,  found 
originally  in  Australia,  and  known  as  the  "  Blue  Gum  Tree." 
These  trees  are  now  growing  in  the  southern  parts  of  Europe 


200  DENTAL    MEDICINE. 


and  the  United  States,  and  northern  Africa,  and  their  pre- 
sence is  thought  to  be  preventive  of  malaria.  The  leaves, 
which  are  ensiform,  of  a  grayish-green  color,  and  parchment- 
like, are  the  only  part  which  possesses  medicinal  qualities. 
They  have  a  pleasant,  aromatic  odor,  with  a  warm,  bitter,  and 
somewhat  pungent  taste,  like  that  of  cubebs,  the  fresh  being 
more  active  than  the  dried  leaves.  Their  medicinal  virtue  is 
owing  to  a  volatile  oil — Oleum  Eucalypti — which  contains  three 
principles,  called  eiicalyptene,  tiirpene,  and  cymol.  Tannic  acid, 
and  a  peculiar  crystalline  fatty  acid,  are  also  found  in  eucalyp- 
tus ;  but  eucalyptene  is  the  most  important  constituent. 

Medical  Properties  and  Action.  Eucalyptus  is  antiseptic, 
disinfectant,  sedative,  tonic,  diaphoretic,  and  somewhat  astrin- 
gent. When  taken  into  the  mouth,  it  excites  the  flow  of  saliva, 
and  leaves  a  hot,  pungent,  persistent  and  disagreeable  odor. 
When  introduced  into  the  stomach,  it  causes  a  sensation  of 
warmth,  and  promotes  the  secretion  of  the  gastric  juice.  Being 
stomachic,  it  increases  the  appetite  and  the  digestive  action, 
with  increased  intestinal  secretion.  Large  doses  produce  offen- 
sive eructations,  a  feeling  of  weight  and  tension  at  the  epigas- 
trium, and  indigestion,  followed  by  diarrhoea,  and  irritation  and 
congestion  of  the  kidneys.  It  increases  the  action  of  the  heart, 
lessening  the  arterial  tension,  and  causes  a  feverish  condition. 
It  accelerates  the  respiratory  movements,  and  although  it  in- 
duces sleep  in  the  weak  and  anaemic,  it  has  the  opposite  effect 
upon  the  strong  and  healthy.  The  secretions  of  the  skin, 
mucous  membrane  and  kidneys  are  increased  by  it,  and  become 
strongly  odorous,  owing  to  the  presence  of  eucalyptol,  a  name 
given  to  the  oil.  The  inhalation  of  large  quantities  of  the 
vapor  produces  effects  analogous  to  those  of  the  agent  when 
taken  in  substance,  and  the  essential  oil  is  readily  diffusible 
and  readily  impregnates  the  blood. 

Therapeutic  Uses.  While  the  internal  use  of  eucalyptus  is 
contraindicated  in  inflammatory  conditions,  it  is  a  very  efficient 
remedy  in  atonic  dyspepsia ;  chronic,  gastric,  and  intestinal 
catarrh,  cachectic  conditions,  flatulence,  palpitation  of  the  heart, 
hysteria,  chorea,  asthma,  catarrhal  broncho-pulmonary  affec- 


EUCALYPTUS EUCALYPTUS.  201 


tions,  chronic  diseases  of  the  hver  and  bladder,  etc.  It  is  also  em- 
ployed in  intermittent  fever,  and  during  convalescence  from  re- 
mittent fever.  Externally,  it  is  an  efficient  application  to  chronic 
forms  of  angina  and  tonsillitis,  to  foul  ulcers  and  wounds,  etc. 

Dose.  Of  the  fluid  extract  of  Eucalyptus,  5ss— 3j ;  of  the 
tincture  of  eucalyptus — Tinctura  Eucalypti — f5ss  to  foij ;  of 
the  extract — Extractiim  Eucalypti — gr.  j  to  3j ;  of  eucalyptol, 
the  dose  is  rr^v  to  5ss,  in  capsules  or  emulsion. 

Dental  Uses.  In  dental  practice,  the  decoction  of  the  leaves 
is  an  efficient  local  application  in  the  different  forms  of  stoma- 
titis, after  the  acute  stage  has  subsided.  The  tincture  and  the 
distilled  water  are  used  as  disinfectant  applications  in  indolent 
offensive  ulcers  of  the  mucous  membrane  of  the  mouth.  The 
tincture  of  eucalyptus  has  been  employed  with  advantage  to 
obtund  the  sensibility  of  dentine.  The  oil  of  eucalyptus,  either 
alone  or  combined  with  iodoform,  forms  one  of  the  most 
effective  antiseptics  in  use,  for  the  treatment  of  putrescent  pulps 
of  teeth,  alveolar  abscess,  of  the  chronic  form,  foul  ulcers  of 
the  mouth,  etc. 

No  other  antiseptic  preparation  appears  to  prove  more  effi- 
cient as  an  antiseptic  than  the  combination  of  eucalyptus  oil 
and  iodoform,  in  the  treatment  of  suppurating  conditions, 
necrosis,  and  caries  of  the  bones  of  the  jaws,  etc.  The  oil  can 
be  introduced  as  an  injection,  with  an  abscess  syringe,  or  by 
means  of  a  fine  broach,  armed  with  cotton,  taking  care  that 
the  agent  is  carried  to  the  seat  of  the  disease,  and  the  applica- 
tion repeated  as  often  as  is  necessary.  It  is  also  employed  as  a 
local  anaesthetic  for  odontalgia,  and  as  an  astringent  or  styptic  in 
superficial  hemorrhages,  mucous  discharges,  ulcerating  mucous 
membrane  of  the  mouth,  and  for  spongy,  ulcerating  gums. 

DENTAL  FORMULA. 
For  Suppurating  Pulps,  Ulcers,  etc. 

K.     Olei  Eucalypti ^j 

lodoformi gr.  xv.   M. 

SiGNA. — Apply  as  an  injection,  by  means 
of  a  syringe ;  or  on  cotton  wrapped  on 
the  end  of  a  fine  broach;  or  on  a  strand 
of  floss-silk. 

14 


202  DENTAL    MEDICINE. 


For  Abscess  of  Antrutn.  For  Alveolar  Pyorrhoea 

Geo.  L.  Parmele.  {Rigg's  Disease). 

R.     Eucalypti 7^]  G.  V.  Black. 

lodoformi gr- x  R.     Olei  Eucalypti fri^xc 

Aquse ^j.        M.  Acidi  Carbolici ll^^xc 

SiGNA. — To  be  used  as  an  injection  in  Olei  Gaultherise TTLxxx.  M. 

connection  with  a  tent  of  floss  silk  SiGNA. — Apply  by  means  of  an  abscess 

saturated  with  glycerine    and  euca-  syringe. 

lyptus. 

FERRUM— IRON. 

Chemical  analysis  demonstrates  the  presence  of  iron  in  the 
blood,  the  gastric  juice,  chyle,  lymph,  bile,  milk,  urine  and  the 
pigment  of  the  eye  ;  and,  although  metallic  iron  is  inert,  yet, 
when  it  reaches  the  stomach,  it  is  dissolved  by  the  acids,  and 
thus  acquires  molecular  activity.  By  its  oxidation  in  the 
stomach  hydrogen  is  set  free,  which  in  its  nascent  state  unites 
with  sulphur,  forming  sulphuretted  hydrogen. 

Medical  Properties  and  Actio7i.  The  salts  of  iron  act  through 
and  upon  the  blood,  improving  its  quality  and  increasing  its 
quantity,  and  hence  they  are  termed  "  haematinic."  These  salts  of 
iron  are  absorbed  into  the  system,  and  are  detected  in  the  blood, 
urine,  etc.,  and  under  their  use  the  appetite  increases,  the  diges- 
tion is  improved,  the  pulse  increases  in  frequency  and  fullness, 
the  health  becomes  better,  and  there  is  an  increase  in  flesh  and 
an  improvement  in  color;  hence  they  are  "  restoratives."  As 
these  salts  of  iron  in  large  doses  cause  nausea  and  vomiting, 
being  irritant  poisons,  and  even  small  doses,  when  adminis- 
tered for  a  long  period,  exhaust  the  gastric  glands  by  over- 
stimulation, their  use  is  contra-indicated  in  a  plethoric  condi- 
tion, especially  when  accompanied  with  a  hemorrhagic  ten- 
dency, or  when  there  is  an  atheromatous  state  of  the  cerebral 
vessels.  Certain  of  these  salts,  such  as  the  sulphates,  the 
chlorides,  and  the  nitrates,  possess  a  high  degree  of  astrin- 
gency,  and  when  taken  internally  produce  constipation. 
Brought  in  contact  with  the  blood,  they  coagulate  it,  and 
solidify  the  albuminous  elements  of  the  tissues,  being  powerful 
"  haemostatics." 

Without  great  care  is  exercised  in  the  internal  administra- 


FERRUM IRON.  203 


tion  of  iron,  owing  to  the  acidity  and  astringent  property  of 
many  of  these  preparations,  injury  results  to  the  teeth,  upon 
which  they  act  with  great  energy.  The  tincture  of  the  chlo- 
ride and  the  sulphate,  as  shown  by  the  experiments  of  Dr. 
Smith,  of  Edinburg,  Scotland,  are  more  corrosive  than  the 
wine  of  iron,  and  even  more  injurious  than  the  compounds  of 
iron  with  the  vegetable  acids.  The  use  of  an  alkaline  gargle 
of  carbonate  of  soda,  or  prepared  chalk,  or  solution  of 
ammonia,  before  and  after  the  taking  of  the  iron  preparation 
into  the  mouth,  and  the  subsequent  employment  of  an  antacid 
dentifrice,  will  obviate  the  injurious  effects  of  these  salts  of  iron 
upon  the  teeth.  The  preparation  known  as  dialysed  iron — 
Ferrum  Dialysatum — which  is  iron  in  the  colloid  state,  made 
by  the  process  of  diffusion,  is  odorless,  without  the  styptic 
taste  of  the  other  preparations,  and  does  not  discolor  the  teeth, 
being  free  from  irritant  action ;  neither  does  it  cause  consti- 
pation, and  hence  is  the  best  form  in  which  to  administer  iron. 
The  dose  of  dialysed  iron  is  n\^v  to  5j. 

Therapeutic  Uses  of  Iron.  Iron  is  an  efficient  tonic,  and 
promotes  the  appetite  and  the  digestion ;  hence  it  is  employed 
in  anaemia,  chlorosis,  combined  with  quinine,  in  chronic  mala- 
rial affections;  syphilitic  cachexia,  acute  rheumatism,  erysipelas, 
diphtheria,  scrofula,  rickets,  neuralgia  depending  on  anaemia, 
epilepsy  in  weak,  anaemic  subjects,  fatty  degeneration  of  the 
heart,  passive  forms  of  hemorrhage  due  to  anaemia,  albumi- 
nuria, etc.,  etc.  Externally  the  styptic  preparations  of  iron  are 
employed  to  arrest  hemorrhage — hemorrhage  from  leech  bites, 
hemorrhage  following  the  extraction  of  teeth,  hemorrhage 
resulting  from  wounds  and  surgical  operations,  etc.,  etc. 

[For  doses  of  the  various  preparations  of  iron,  see  "  Table 
of  Doses."] 

Chloride  of  Iron — Ferri  Chloridiun — Perchloride  of  Iron, 
Formula.  Fe2Cl6,i2H20.  Is  obtained  by  heating  iron  wire 
with  hydrochloric  acid,  and  afterwards  converting  the  ferrous 
chloride  thus  formed  into  ferric  chloride  by  heating  it  with 
hydrochloric  and  nitric  acids.  It  is  in  the  form  of  crystalline 
masses  of  an  orange  yellow  color,  inodorous  and  of  a  strong 


204  DENTAL    MEDICINE. 


styptic  taste.  It  is  deliquescent  and  readily  soluble  in  water, 
alcohol  and  ether.  It  is  used  internally  in  the  form  of  tincture 
— Tinctitra  Fe^nd  Chloridi.     Dose,  r(\y  to  tt^xx. 

Externally  the  chloride  of  iron  is  employed  as  a  styptic  and 
for  an  astringent,  for  the  latter  purpose  being  in  solution  of 
various  strength. 

Dental  Uses.  In  dental  practice  the  chloride  of  iron  is  used 
internally  for  the  treatment  of  neuralgia  when  it  is  attended  with 
anaemia ;  also  externally,  for  the  arrest  of  alveolar  hemorrhage, 
although  the  preference  is  given  to  the  solution  or  powder  of 
the  subsulphate.  The  chloride  of  iron  may  be  used  in  the 
semi-deliquesced  or  crystallized  form,  or  in  solution — Liquor 
Ferri  Perchloridi — which  is  preferred  by  some  to  the  crystal- 
lized. To  bleeding  surfaces  it  is  applied  in  the  proportion  of 
5ss  to  5vj  to  the  ounce  of  water.  One  part  of  the  chloride 
gradually  added  to  six  parts  of  collodion,  in  the  form  of  a 
yellowish-red,  limpid  liquid,  makes  a  valuable  styptic.  Chlo- 
ride of  iron  is  also  useful  as  an  application  to  fungous  tumors. 

Solution  of  Subsulphate  of  Iron — Liquor  Ferri  Sub- 
siilphatis — Monsel's  Solution — is  composed  of  sulphate  of  iron, 
oxij ;  sulphuric  acid,  Sj  and  gr.  xxx ;  nitric  acid,  gr.  ccclx. 
It  is  of  a  syrupy  consistence  and  a  ruby  red  or  dark  brown 
color,  no  odor  or  acrid  taste,  but  possesses  powerful  astringent 
properties. 

Powdered  Subsulphate  of  Iron — Pulvis  Ferri  Subsulphatis 
— Monsel's  Powder — is  in  the  form  of  a  yellow  powder,  and 
possesses  the  same  astringent  and  other  properties  as  the 
solution,  and  is  applied  as  a  styptic  in  alveolar  hemorrhage 
with  much  greater  convenience. 

Medical  Properties  and  Action.  Monsel's  solution  and  powder 
act  topically  as  powerful  astringents  and  mild  caustics,  and  are 
considered  to  be  among  the  best  styptics  in  use.  These  styp- 
tics combine  with  albumen  and  form  a  pale  yellow  compound, 
and  on  this  property  depends  their  chemical  action  on  the 
tissues  of  the  body.  Internally  administered  they  act  like  the 
sulphate  of  iron,  their  remote  effect  being  tonic  and  haemo- 
static.    In  small  doses  they  exert  an  astringent  effect  on  the 


FERRUM IRON.  205 


gastro-intestinal  mucous  membrane,  diminishing  the  quantity 
of  fluids  secreted  or  exhaled ;  hence  their  constant  use  will 
cause  constipation. 

Monsel's  preparations  of  iron  are  principally  used  exter- 
nally for  hemorrhage  from  bleeding  vessels.  When  employed 
internally  it  is  for  the  arrest  of  hemorrhage  from  remote 
organs. 

Therapeutic  Uses.  The  solution  and  powder  of  the  sub- 
sulphate  of  iron  are  used  internally  for  hemorrhage  from  the 
stomach  and  bowels.  Externally,  for  hemorrhage,  varicose 
ulcers,  etc.,  etc. 

Dose.  Of  the  solution  of  subsulphate  of  iron,  gtt.  v  to  gtt. 
X,  twice  a  day,  in  some  bitter  infusion.  Of  the  powdered 
subsulphate  of  iron  the  dose  is  gr.  v  to  gr.  xv.  The  solution  is 
also  given  in  small  doses  with  the  sulphate  of  magnesia,  as  an 
artificial  chalybeate  purging  water. 

Dental  Uses.  In  dental  practice  Monsel's  solution  and 
powder  are  principally  employed  for  arresting  hemorrhage 
following  the  extraction  of  teeth,  hemorrhage  from  leech  bites, 
and  also  from  other  causes,  such  as  wounds  of  the  gums  and 
mucous  membrane,  in  the  treatment  of  ulcers  of  the  mouth; 
and  the  solution,  diluted  with  water,  forms  a  serviceable  appli- 
cation for  abraded  and  inflamed  mucous  surfaces. 

For  Hemorrhage  Following  the  Extraction  of  Teeth. 
— After  carefully  cleansing  the  bleeding  cavity  as  thoroughly 
as  possible,  the  styptic  should  be  applied  on  a  pellet  of  cotton, 
or,  in  case  the  powdered  subsulphate  of  iron  is  employed,  on  a 
pellet  of  cotton  previously  dipped  in  sandarach  varnish,  to 
which  the  powder  will  adhere,  and  inserted  over  the  mouth 
of  the  bleeding  vessel  at  the  apex  of  the  alveolar  cavity. 
Cotton  should  then  be  inserted  over  the  styptic  preparation, 
and  the  alveolar  cavity  be  thoroughly  filled  up.  If  necessary, 
a  compress,  made  from  a  cork,  should  be  applied  over  the 
cotton  filling  the  cavity,  and  held  in  place  by  the  opposing 
teeth  when  the  mouth  is  closed. 


206  DENTAL   MEDICINE. 


DENTAL  FORMULA. 

For  Hemorrhage  from  Extraction  of  Teeth. 

Steere. 
B  .     Liq.  Ferri  Persulph, 

Sodium  Chlor..aa..partes  aequales.    M. 
SiGNA. — Apply  on  cotton  to  bleeding  cavity 
and  secure   by  covering  with   a  roll    of 
cotton  cloth. 

GELSEMIUM— YELLOW  JASMINE. 

Source.  Gelsemium  is  obtained  from  the  root  of  the  gelse- 
iniiim  sempervirens — yellow  jasmine — woodbine,  belonging  to 
the  natural  order  Apocynaceae,  which  grows  plentifully  in  the 
southern  United  States.  The  root  is  of  a  brownish  color  ex- 
ternally, and  a  grayish  color  within,  and  is  sold  in  small  pieces, 
from  one-half  to  two  inches  in  length,  and  a  quarter  of  an  inch 
in  thickness,  being  hard  and  slightly  cracked  longitudinally. 
It  has  a  bitter  taste  and  an  aromatic  odor,  somewhat  like  that 
of  green  tea. 

Medical  Properties  and  Action.  Gelsemium  has  a  depressing 
and  sedative  influence  upon  the  nervous  centres,  and  dimin- 
ishes the  force  and  frequency  of  the  heart's  action.  It  contains 
a  very  powerful  alkaloid,  gelsernia  or  gelseinina,  which  is  color- 
less, odorless,  with  an  intensely  bitter  taste, 

Gelsemium,  in  moderate  doses,  causes  a  languid  feeling, 
attended  with  mental  calmness,  slow  action  of  the  heart, 
drooping  eyelids,  dilatation  of  the  pupil,  and  some  feebleness 
of  muscular  movements.  In  larger  doses  it  causes  vertigo, 
double  vision,  amblyopia,  paralysis  of  the  muscle  that  elevates 
the  upper  eyelid,  so  that  it  cannot  be  raised,  dilated  pupil, 
labored  respiration,  on  account  of  its  effect  upon  the  respiratory 
muscles,  slow  and  feeble  movement  of  the  heart,  great  muscular 
weakness,  and  a  reduced  sensibility  to  pain  and  touch.  Such 
effects  occur  about  half  an  hour  after  the  gelsemium  is 
taken,  and  continue  for  two  or  three  hours,  when  they  dis- 
appear. 

When  poisonous  doses  are  taken,  all  of  the  symptoms  des- 
cribed above  occur  in  a  more  intense  degree,  and  there  is  first 


GLYCERINUM GLYCERIN.  207 

an  unsteady  gait,  until  all  muscular  power  is  lost,  the  lower 
jaw  drops,  the  muscles  of  the  tongue  are  paralyzed,  speech 
being  impossible,  the  respirations  are  very  labored,  slight  and 
irregular,  and  the  action  of  the  heart  weak,  feeble  and  inter- 
mittent, and  generally  the  skin  is  covered  with  a  profuse 
perspiration.  Death  occurs  from  asphyxia,  but  consciousness 
is  preserved  until  near  the  end,  which  is  generally  calm,  and 
not  disturbed  by  convulsions. 

Therapeutic  Uses.  Gelsemium  is  internally  administered  in 
tetanus,  mania,  convulsive  or  spasmodic  cough,  such  as  whoop- 
ing cough ;  pneumonia,  remittent  and  typho-malarial  fevers, 
ovarian  and  other  forms  of  neuralgia,  cerebro-spinal  meningitis, 
pleuritis,  etc.,  etc. 

Dose.  Of  the  fluid  extract  of  gelsemium — Extractuni  Gel- 
semii  FLuidiim — the  only  officinal  preparation,  rr^v  to  ttlxv.  Of 
the  tincture  of  gelsemium — TmcUira  Gelseinii — (gelsemium,  oiv, 
alcohol,  Oj),  the  dose  is  gtt.  x  to  gtt.  xx.  The  fluid  extract  is 
preferable  for  administration,  but  one  fluidrachm  of  this  has 
caused  death.     Dose  of  the  alkaloid  gelsemia,  gr.  ^V  to  gr.  i^. 

Dental  Uses.  Gelsemium  is  greatly  extolled  as  a  remedy  for 
neuralgia  of  the  fifth  nerve,  often  affording  permanent  relief, 
especially  when  the  affection  is  associated  with  diseased  teeth. 
The  dose  may  be  repeated  at  any  time  after  an  hour  and  a 
half,  if  the  pain  is  not  relieved;  a  third  dose  is  seldom  required. 
In  neuralgia  of  the  face  or  head,  three-minim  doses  of  the 
tincture  of  gelsemium  every  half  hour,  will  often  act  very 
beneficially,  and  leave  no  ill  effects.  Owing  to  the  toxic  effects 
of  this  drug,  care  is  necessary  that  the  dose  is  a  moderate 
one,  and  the  symptoms  carefully  observed. 

GLYCERINUM— GLYCERIN. 

Formula.     CgHg  3HO.     Sp.  gr.  1.25. 

Source.  Glycerin  is  obtained  from  the  saponification  of  fats 
and  fixed  oils,  and  contains  a  small  percentage  of  water.  It  is  a 
colorless,  inodorous,  syrupy  liquid,  of  a  sweet  taste,  and  freely 
soluble  in  water  and  alcohol,  but  not  in  ether   or   chloroform. 


208  DENTAL   MEDICINE. 


Medical  Properties  and  Action.  Glycerin  is  nutrient  and 
emollient,  possessing  considerable  power  as  a  solvent  and 
preservative.  The  addition  of  y^,  /^,  or  even  ^V  part  of 
glycerine  to  a  lotion,  or  a  poultice,  or  an  external  application, 
renders  it  particularly  emollient  and  soothing.  It  keeps  the 
parts  moistened  and  soft  and  corrects  or  prevents  the  disagree- 
able odor  of  discharges,  and  it  does  not  evaporate  or  dry  at 
any  ordinary  temperature.  Glycerin  dissolves  carbolic  acid, 
creasote,  tannic  acid,  borax,  iodine,  quinine,  iodide  of  potassium, 
gallic  acid,  etc.,  and  its  uses  as  a  solvent  and  vehicle  for  other 
remedies  are  very  numerous.  It  has  been  prescribed  as  a 
substitute  for  cod-liver  oil  where  the  latter  nauseates.  Offici- 
nal solutions  of  medical  agents  in  glycerin  are  known  as 
glycerites  (^glycerita?) 

Therapeutic  Uses.  Glycerin  is  rarely  used  alone  as  an 
internal  remedy,  its  chief  use  being  external,  or  in  combination 
with  other  medicinal  substances.  It  has  been  prescribed  in 
phthisis,  diabetes,  acne  ;  externally,  as  an  emollient  in  acute 
coryza,  chronic  follicular  pharyngitis,  chapped  hands  and  face, 
fissures,  skin  diseases,  dressing  for  wounds  and  ulcerated 
surfaces,  and  as  a  vehicle  for  the  application  of  astringents  to 
the  eye ;  also  to  soften  cerumen  and  for  the  removal  of  insects 
from  the  ear,  and  to  diminish  the  secretion  of  pus ;  also  in 
burns,  abraded  surfaces,  erysipelas,  etc.  It  has  also  been 
employed  in  smallpox  as  an  emollient  and  to  prevent  pitting, 
a  mixture  of  one  part  of  glycerin  and  two  parts  of  rose  water 
being  applied  after  the  pustules  have  broken  and  the  discharge 
has  commenced  to  dry.  It  is  applied  for  a  few  days,  until  the 
scabs  begin  to  loosen.  Glycerin  is  also  used  in  croup,  locally 
applied  to  the  glottis ;  also  in  deafness,  where  the  auditory 
canal  is  dry  and  inelastic.  For  an  emollient  application  it  is 
frequently  combined  with  other  agents,  and  used  in  the  form 
of  an  ointment  or  an  embrocation.  Five  parts  of  glycerin 
rubbed  up  in  a  mortar  with  four  parts  of  yolk  of  &^%,  forms  a 
compound  which  prevents  the  action  of  the  air  from  irritating 
broken  or  abraded  surfaces,  and  is  soothing  in  erysipelas, 
cutaneous  affections,  etc.     Although  glycerin  is  so  bland  in 


GLYCERINUM GLYCERIN.  209 

its  general  character,  yet  it  produces  a  smarting  sensation 
when  first  applied  to  an  abraded  surface  of  the  skin  ;  such  an 
effect  is  thought  to  be  due  to  the  affinity  of  glycerin  for 
moisture,  which  it  abstracts  from  the  skin  so  rapidly  as  to 
cause  the  smarting  sensation ;  mixing  the  glycerin  with  a 
little  water  will  obviate  this.  Pure  glycerin  when  mixed  with 
water  will  raise  the  temperature  eight  or  ten  degrees,  and 
hence  the  two  should  be  combined  previous  to  its  application. 

Dose.     Of  Glycerin  5j  to  5ij- 

Dental  Uses.  Glycerin  is  a  useful  agent  in  dental  practice  as 
a  solvent  and  emollient,  as  a  solvent  alone,  and  as  both 
solvent  and  emollient,  when  combined  with  other  substances. 

It  is  employed  with  great  benefit  in  such  affections  as  diseases 
of  the  mucous  membrane  of  the  mouth,  such  as  the  different 
forms  of  stomatitis,  for  ulcers  of  the  mouth,  aphthae,  alveolar 
abscess,  abraded  surfaces  from  the  irritation  of  acrid  substances, 
artificial  teeth,  etc. 

In  the  treatment  of  inflamed  and  ulcerated  conditions  of  the 
mucous  membrane,  it  is  frequently  combined  with  borax,  and 
for  chronic  alveolar  abscess,  or  after  the  use  of  more  active 
agents,  and  diseases  of  mucous  membrane,  it  is  combined  with 
carbolic  acid,  iodine,  sulphite  of  soda,  etc.  As  an  anodyne 
and  emollient  application,  glycerin  is  combined  with  morphine, 
atropine,  acetate  of  lead,  etc.,  etc.  To  form  ointments  and 
embrocations,  it  is  combined  with  gum  tragacanth,  lime  water, 
oil  of  almonds,  rose  water,  etc.,  etc. 

DENTAL  FORMULA. 

For  Chronic  Abscess,  Ulcerations,  etc.  For   InJlainmatio7i   and  Ulceration   of 

R.     Glycerini gj  the  Mucous  Membrane. 

Tinct.  lodi.  Comp tT\^xlv  R-     Glycerini ^j 

Acidi  Carbolici  Cryst... rT\^vj  Sodii  Boratis ^ij.       M. 

Aquse  Destillatse ^v.       M.  Signa. — Apply  as  a  lotion. 

SiGNA. — Apply  as  a  lotion  or  injection. 

For  Chronic  Alveolar  Abscess,  Ulcera- 
For  Aphthous  Ulceration  of  the  Mouth.  tions  of  Mucous  Membrane,  etc. 

R.     Glycerini ^^j  R.     Glycerini partem  i 

Sodii  Sulphitis ^j.        M.  Acidi  Tannici partes  2. 

Signa. — Apply  as  a  lotion. 


210  DENTAL    MEDICINE. 


For  a  Sedative  Application  in  Inflamed       For  Pulp  Canals  of  Abscessed  Teeth. 

Mucous  Me77ibrane.  Faught. 

R.     Glycerini  R.     Glycerini f^ij 

Chloroformi aa ^  ss.  M.              Acidi  Tannici gij 

SiGNA. — Apply  as  a  lotion.  Morphia  Acetatis '2^\ 

For  Pulpitis.  lodoformi ^j.       M. 

R,     Glycerini gtt.  ij  SiGNA. — Apply  on  floss  silk  or  cotton. 

Acid  Carbolic gr.  v  For  Aphthous  Sore  Mouth  of  Infants. 

Tr.  Aconit.  rad.  R.     Glycerini 

Aq.  Menth.  pip aa...gtt.  ij  Aquse aa §ss 

Acid.  Tannic gr.  j  Sodium  Sulph gr.xxx.  M. 

01.  Menth.  pip.  SiGNA. — Use  on  swab  every  2  hours. 

01.  Caryophilli....aa. ...gtt.xxv. M. 
SiGNA. — Apply  on  cotton. 


HAMAMELIS— HAMAMELIS. 
Witch  Hazel. 

Source.  Hamamelis  Virginica  is  an  indigenous  shrub,  com- 
mon to  all  parts  of  the  United  States  and  Canada,  and  usually- 
found  in  stony  places  and  on  the  banks  of  streams.  The  bark 
and  leaves  are  the  medicinal  portions. 

Medical  Properties  and  Action.  It  is  tonic,  astringent,  seda- 
tive, and  anodyne.  The  bark  has  a  bitter,  astringent,  and  some- 
what sweetish  and  pungent  taste,  and  was  first  employed  by 
the  Indians  as  a  sedative  and  discutient  application,  in  painful 
tumors  and  other  cases  of  superficial  inflammation.  The  bark 
contains  from  eight  to  ten  per  cent,  of  tannic  acid,  and  also  a 
bitter  principle. 

Therapeutic  Uses.  Hamamelis  Virginica,  although  not  until 
recently  officinal,  has  for  some  time  been  employed  in  hemor- 
rhage of  the  lungs,  haematemesis,  and  in  phthisis.  Exter- 
nally, it  is  applied  to  tumors,  inflamed  and  painful  parts,  etc., 
etc.,  in  the  form  of  a  fluid  extract,  decoction  and  tincture. 
Two  minims  of  the  tincture  of  hamamelis  every  half  hour,  will 
often  control  hemorrhages  from  nose,  uterus  and  from  hemor- 
rhoids. 

Dose.  Of  fluid  extract  of  Hamamelis,  5ss  to  5ij ;  of  the 
decoction,  oss  to  Sj. 

Dental  Uses.     Hamamelis  is  employed  in  dental  practice  as 


HYDRARGYRUM MERCURY.  211 

a  sedative  or  anodyne  application,  in  incipient  dental  periostitis, 
in  the  form  of  the  fluid  extract,  applied  w«rw  on  lint  or  cotton, 
as  a  lotion;  also  as  an  anodyne,  to  irritated  and  painful  exposed 
pulps  of  teeth  ;  also  for  passive  hemorrhage  from  the  mucous 
membrane  of  the  mouth ;  also  for  the  soreness  arising  from 
the  removal  and  effects  of  salivary  calculus.  The  tincture  may 
be  applied  as  a  sedative  lotion,  in  the  proportion  of  one  part 
to  ten  of  water. 

HYDRARGYRUM— MERCURY. 

Quicksilver. 

Formula.     Hg.     Sp.  gr.  13.5. 

Sources.  Mercury  is  a  metal  of  a  nearly  silver-white  color 
and  a  very  high  degree  of  lustre.  It  is  liquid  at  all  ordinary 
temperatures,  and  only  solidifies  when  cooled  to  40°.  It  fuses 
at  39°  F.,  and  readily  volatilizes  at  662°  F. ;  it  boils  and  yields 
a  transparent,  colorless  vapor,  of  great  density.  It  also  volatil- 
izes somewhat  at  ordinary  temperatures,  and  especially  above 
68°  F.  The  ordinary  ore  from  which  metallic  mercury  is 
obtained  is  the  mercuric  sulphide,  although  it  is  occasionally 
met  with  in  globules  disseminated  through  this  native  sulphide, 
and  which  is  noted  as  cinnabar.  There  is  also  a  form  known 
as  horn  silver  or  native  calomel,  and  a  native  amalgam  of  silver 
and  mercury.  California  furnishes  metallic  mercury  of  a 
peculiar  purity,  in  large  quantities.  The  metal  is  obtained  from 
the  sulphide  by  the  process  of  "  roasting."  When  pure, 
metallic  mercury  does  not  readily  tarnish  in  the  air,  and  it  can 
be  purified  by  re-distillation,  or  by  adding  to  it  a  small  quan- 
tity of  a  strong  solution  of  nitrate  of  mercury. 

The  impurities  are  generally  dirt,  dust,  lead,  tin,  bismuth  or 
zinc. 

Dental  Uses.  Metallic  mercury  is  employed  in  dental 
practice  as  an  ingredient  of  amalgam  filling  material,  being 
combined  for  such  a  purpose  with  silver,  tin  and  zinc,  and 
sometimes  with  gold  and  platinum,  in  addition  to  the  other 
metals  named. 

Hydrargyri   Chloridum  Corrosivum — Corrosive  Chloride 


212  DENTAL    MEDICINE. 


of  Mercury — Corrosive  Sublimate.   Mercuric  Chloride.   Formula. 

Derivation.  Corrosive  sublimate  is  obtained  by  subliming  a 
mixture  of  chloride  of  sodium  and  mercuric  sulphate,  the  latter 
made  by  boiling  together  sulphuric  acid  and  mercury ;  double 
decomposition  takes  place,  forming  mercuric  chloride  and 
sulphate  of  sodium.  Corrosive  sublimate  is  in  the  form  of 
colorless  crystals,  or  crystalline  masses,  which  are  inodorous, 
fusible,  and  sublime  without  residue,  and  of  an  acrid,  styptic 
taste.  It  is  readily  soluble  in  15  parts  of  water,  7  parts  of 
alcohol  and  ether. 

Medical  Properties  and  Action.  (See  Hydrargyri  Chloridum 
Mite.) 

Therapeutic  Uses.  Corrosive  sublimate  is  alterative  in  small 
doses,  and  in  large  quantities  is  a  powerful  irritant  poison, 
corroding  the  stomach  and  causing  death  in  a  very  few  hours. 
Its  continued  use  has  caused  salivation,  but  it  has  a  less  ten- 
dency to  produce  such  an  effect  than  the  other  preparations  of 
mercury.  Internally  it  is  employed  in  secondary  syphilis,  chronic 
diarrhoea  and  dysentery.  Externally  in  diseases  of  the  eye, 
diseases  of  the  skin,  ulcers,  gonorrhoea  and  gleet,  etc.,  etc. 
The  external  application  to  large  surfaces  is  dangerous.  Its  use 
is  contra-indicated  in  patients  affected  with  pulmonary  disease. 

For  cases  of  poisoning  the  antidotes  are  albumen,  white  of 
^ZZ>  wheat  flour,  milk,  etc. 

Dose.  Of  Corrosive  Sublimate  gr.  3V  to  gr.  xV,  in  pill  or  solu- 
tion. 

Dental  Uses.  It  is  employed  as  a  lotion,  injection  or  gargle 
in  chronic  diseases  of  the  mucous  membrane,  ulcers,  etc. 

Hydrargyri  Chloridum  Mite — Mild  Chloride  of  Mercury. 
Calomel.     Mercurous  Chloride.     Formida.     HgCl. 

Derivation.  Calomel  is  obtained  by  subliming  a  mixture  of 
mercurous  sulphate  and  chloride  of  sodium,  a  double  decom- 
position taking  place,  by  which  mercurous  chloride  and  sul- 
phate of  sodium  are  formed.  The  mercurous  sulphate  thus 
employed  is  obtained  by  boiling  mercury  in  sulphuric  acid 
and  triturating  the  resulting  mercuric  sulphate  with  mercury. 


HYDRARGYRUM MERCURY.  213 

To  remove  any  corrosive  sublimate  which  the  calomel  may 
contain  it  is  washed  with  hot  distilled  water  until  the  absence 
of  a  white  precipitate  with  ammonia  shows  that  the  poisonous 
ingredient  has  been  removed.  Calomel  is  in  the  form  of  a 
white,  inodorous,  tasteless  powder,  insoluble  in  water,  alcohol, 
and  ether,  and  wholly  volatilized  by  heat.  Calomel  is 
incompatible  with  the  alkalies,  and  alkaline  earths  and  alkaline 
carbonates,  with  lead,  copper  and  iron.  When  nitro-muriatic 
acid  is  combined  with  it,  corrosive  sublimate  is  formed ;  neither 
should  it  be  given  in  combination  with  iodine. 

Medical  Properties  and  Action.  Calomel  and  the  other 
mercurials  are  employed  as  alteratives,  sialagogues,  purgatives, 
diuretics,  etc.,  and  moderate  doses  increase  the  action  of  the 
secreting  glands  and  organs,  stimulating  the  salivary  glands  in 
a  very  decided  manner.  When  large  doses  are  administered 
the  effects  are  manifested  on  the  gums,  which  become  tender 
and  swollen,  the  salivary  glands  take  on  increased  action,  the 
saliva  and  buccal  mucus  flow  profusely,  the  mucous  mem- 
brane of  the  mouth  becomes  inflamed  and  ulcerated,  the  tongue 
swollen  and  the  breath  fetid,  with  a  metallic,  coppery  taste,  and 
the  teeth  become  loose,  such  symptoms  constituting  the  condi- 
tion known  as  salivation.  When  the  use  of  the  drug  is  dis- 
continued these  symptoms  disappear,  but  the  mucous  mem- 
brane and  gums  are  ever  after  more  susceptible  to  irritation, 
and  the  stability  of  the  teeth  is  more  or  less  impaired,  as  is 
shown  by  the  recession  of  the  gums  and  the  absorption  of  the 
alveolar  processes.  In  many  cases  the  gums,  especially  about 
the  necks  of  the  teeth,  remain  somewhat  tumefied,  with  a 
tendency  to  ulceration. 

If  the  use  of  the  mercury  is  continued  beyond  the  stage 
which  the  symptoms  just  described  indicate,  or  even  as  the 
effects  of  small  doses  in  persons  very  susceptible  to  the 
influence  of  mercury,  an  excessive  salivation  ensues,  with 
serious  ulceration  of  the  gyms  and  mucous  membrane  of  the 
mouth,  loss  of  the  teeth,  and  even  necrosis  of  the  bones  of  the 
jaws.  Mercury  has  also  the  effect  of  causing  considerable 
emaciation,  from  the  absorption  of  fat,  and  sometimes  a  peculiar 


214  DENTAL    MEDICINE. 


febrile  state  known  as  mercurial  fever  ;  and  also  diarrhoea,  skin 
diseases,  rheumatism,  neuralgia  and  disorder  of  nervous  system. 
Mercury,  after  it  is  absorbed,  has  a  decided  effect  upon  the 
blood,  which  it  impoverishes,  destroying  the  red  blood  globules 
(hematine  and  globuline) ;  the  blood  contains  more  water,  is 
more  prone  to  putrefaction,  and  the  unnatural  fluidity  predis- 
poses to  hemorrhage,  which  may  become  dangerous. 

Therapeutic  Uses.  Mercury  in  the  form  of  calomel,  blue 
mass  iPilulcB  Hydrargyri — pills  of  mercury — mercury  Sij ; 
confection  of  rose,  Siij,  and  powdered  liquorice  root,  Sj,)  are 
employed  as  sialagogues,  indirect  tonics  and  cholagogues,  and 
purgatives  in  syphilis,  diseases  of  the  skin,  bilious  derange- 
ments, dyspepsia,  acute  glandular  affections,  diarrhoea  and 
dysentery  of  infants,  hepatic  disorders,  croup  and  membranous 
laryngitis,  cholera,  etc.,  etc. 

Dose.  Of  calomel,  gr.  to  to  gr.  x ;  of  blue  pills,  or  mass, 
gr.  ss.  to  gr.  XV.  Mercurials  are  administered  by  the  mouth, 
by  inunction,  by  fumigation,  and  by  the  hypodermic   method. 

Mercurial  Ointment — Ungiientiim  Hydrm'gyri.  Blue  oint- 
ment is  made  by  rubbing  two  parts  of  mercury  with  one  part 
of  suet  and  lard  each,  until  the  globules  disappear.  When 
rubbed  into  the  skin,  it  produces  the  constitutional  effects  of 
mercury,  and  is  applied  to  tumors,  syphilitic  sores,  blistered 
surfaces,  and  is  used  to  destroy  pediculi,  and  also  to  prevent 
suppuration  and  pitting  in  smallpox. 

Mercury  with  Chalk — Hydrargyrum  cum  Creta,  gray 
powder,  consists  of  mercury,  three  parts,  prepared  chalk,  five 
parts.  It  is  a  gentle  laxative,  when  given  in  full  doses,  and  is 
antacid,  and  employed  chiefly  as  an  alterative  in  infantile  diar- 
rhoea, etc. 

Dose.  Of  Mercury  with  Chalk,  for  adults,  gr.  v  to  xx ;  for 
children,  gr.  ss  to  ij,  iij  or  x. 

The  effect  of  mercurial  preparations  upon  children  is  some- 
times very  serious,  as  a  profuse,  or  even  gentle  salivation  will, 
at  times,  cause  mortification  and  destruction  of  the  bones  of 
the  jaw,  the  teeth,  the  cheek,  and  lip ;  and  although  such  cases 
may  not  be  common,  yet,  to  avoid  such  a  powerful  action,  the 


lODOFORMUM IODOFORM.  215 

gums  should   be  frequently  and   carefully  examined,  when   a 
course  of  such  remedies  is  being  pursued. 

DENTAL  FORMULAE. 
For  Febrile  Excitei7ient  of  Dentition.  For  Diarrhoea  of  Dentitioft. 

R.     Calomel gr.  ij  ad  iij     R.     Calomel gr.  ij  ad  vj 

Magnes.  Calc gr.  xxiv  Crete  Ppt  gr.  xviij 

Ipecacuanhae  Pulv gr.  ij  to  iij.  Ipecacuanhas  Pulv gr.  ij 

F.  ch.  No.  xij.  Extract.  Hyoscyami gr. iijadvj. 

SiGNA. — One  to  be  given  every  three         F.  chart.  No.  vj. 

hours.  SiGNA. — One  every  two  or  three  hours, 

according  to  circumstances. 
For  Diarrhoea  of  Teething  Children. 
R .     Hydrargyri  cum  Creta 

Pulv.  Ipecac,  et  Opii..aa..gr.  j.    M. 
SiGN.A.. — One  powder. 
For  Venereal  Sore  Mouth  and  Throat.  For  Warts,  Condylomata,  etc. 

R.     Hydrar.  Chlor.  Corros.gr.  j  R.     Hydrar.  Chlor.  Corros.  gj 

Mellis  Despumati f  5^5  Collodii ^  j.  Solve. 

Aquse  Destillatse ^5^^-     M.     Signa. — To  be  applied  as  a  caustic  with 

SiGNA. — To  be  used  as  a  gargle.  a  camel's-hair  brush. 

lODOFORMUM— IODOFORM. 
Teriodide  of  Formyl. 

Formula.     CHI3. 

Derivation.  Iodoform  is  a  preparation  of  iodine,  being 
obtained  by  the  action  of  chlorinated  lime  upon  an  alcoholic 
solution  of  iodide  ot  potassium,  heated  to  104°  F.,  the  product 
being  iodoform  and  iodate  of  lime,  the  iodoform  being  separ- 
ated by  boiling  alcohol.  It  is  in  the  form  of  small,  pearly 
crystals,  of  a  yellow  color,  with  an  unpleasant  odor,  like  that 
of  saffron,  and  a  sweetish  taste,  and  soft  to  the  touch.  It  is 
volatile,  and  soluble  in  alcohol,  chloroform,  ether,  and  the  fixed 
and  volatile  oils,  but  insoluble  in  water. 

Medical  Properties  and  Action.  Iodoform  has  no  irritant 
action,  and,  in  small  doses,  is  tonic,  stimulant,  anodyne,  altera- 
tive and  disinfectant,  having  great  influence  on  the  nervous 
system ;  it  is  also  antiseptic.  In  large  doses,  it  causes  a  form 
of  intoxication,  followed  by  convulsions  and  fatal  effects.  In 
the  form  of  vapor,  it  possesses  anaesthetic  properties,  but  not 


216  DENTAL    MEDICINE, 


equal  to  those  of  the  general  anaesthetics  in  common  use.  It 
has  also  been  used  as  a  local  anaesthetic,  and  also  as  an  anti- 
septic. Its  odor  can  be  detected  in  the  blood,  the  brain,  and 
the  muscles. 

Therapeutic  Uses.  Iodoform  produces  the  constitutional 
effects  of  iodine,  but  it  is  chiefly  used  externally  for  painful 
cancerous  and  phagedenic  ulcerations,  irritable  ulcers,  ill-con- 
ditioned wounds,  obstinate  skin  diseases,  scrofulous  glandular 
enlargements,  to  allay  the  pain  of  gout  and  neuralgia,  and  for 
phthisis,  mixed  with  starch  and  spread  on  paper,  so  that  the 
vapor  may  be  inhaled.  Dusted  over  a  diseased  surface,  it  allays 
pain  and  changes  the  morbid  action.  A  saturated  solution  of 
iodoform  in  chloroform  is  recommended  for  neuralgia ;  also  a 
saturated  solution  in  any  of  the  essential  oils  is  used  for  the 
same  affection.  In  the  form  of  an  ointment,  it  is  used  as  an 
application  to  irritable  ulcers.  For  ulcerated  surfaces,  it  may 
be  sprinkled  over  the  part,  and  lint,  coated  with  glycerine, 
applied  as  a  dressing. 

Dose.  Of  Iodoform,  gr.  j  to  gr.  iij,  three  times  a  day,  in  the 
form  of  pill. 

Dental  Uses.  Iodoform  is  highly  recommended  in  dental 
practice,  as  an  antiseptic,  either  alone,  or  what  is  better,  com- 
bined with  eucalyptus  oil.  It  possesses  no  escharotic  property 
sufficient  to  cause  irritation  or  the  destruction  of  parts.  In  the 
treatment  of  alveolar  abscess,  iodoform,  in  combination  with 
oil  of  eucalyptus,  has  given  great  satisfaction ;  also  in  cases 
of  putrescent  pulps,  applied  as  an  injection.  It  is  recommended 
to  be  'used  as  follows :  First,  an  injection  of  eucalyptus  oil, 
followed  by  the  introduction  of  the  mixture  of  iodoform  and 
eucalyptus  into  the  root  canal,  on  cotton,  or  on  a  strand  of 
floss  silk,  which  is  charged  by  first  dipping  it  into  the  oil,  and 
then  in  the  iodoform ;  or  the  two  may  be  combined  in  a  solu- 
tion (see  Eucalyptus),  and,  in  this  form,  introduced  into  the 
sac  or  root  canal.  Dr.  C.  N.  Peirce  recommends  iodoform 
ground  up  with  equal  parts  of  oil  of  cloves  and  oil  of  euca- 
lyptus, which  forms  a  substance  of  a  soft,  cheesy  consistence,  a 
portion  of  which  can  be  introduced  to  inflamed  part,  on  the 


lODOFORMUM IODOFORM.  217 

point  of  a  small  broach.  A  saturated  solution  in  eucalyptus  oil 
is  also  serviceable  as  an  external  application  in  neuralgia.  Iodo- 
form is  also  employed  as  an  anodyne,  for  the  relief  of  the  pain 
following  the  extraction  of  teeth  affected  with  periostitis  and 
alveolar  abscess;  also  as  an  injection  in  diseases  of  the  antrum. 
When  iodoform  is  used  alone,  a  pellet  of  cotton  or  a  strand  of 
floss  silk  may  be  dipped  in  glycerine,  and  the  iodoform  be  thus 
taken  up.  To  disguise  the  unpleasant  odor  of  iodoform,  it 
may  be  incorporated  with  a  little  essence  of  rose,  as  half  a 
drop  of  the  essence  will  remove  the  odor  of  sixty  grammes  of 
iodoform  ;  the  odor  is  also  disguised  by  balsam  of  Peru  and  oil 
of  cinnamon.  Three  grains  of  cumurin  (a  derivative  of  the 
Tonka  bean),  will  disguise  the  odor  of  one  drachm  of  iodo- 
form ;  or  the  addition  of  attar  of  rose,  one  minim  to  the 
drachm ;  or  of  essence  of  rose  geranium,  three  or  four  minims 
to  the  drachm.  According  to  some,  it  is  not  a  matter  of 
indifference  whether  iodoform  be  applied  as  a  dressing  for 
wounds  and  ulcers,  in  the  form  of  crystals,  as  amorphous 
powder  dissolved  in  ether,  or  as  an  ointment.  Iodoform 
acts  not  only  as  a  chemical  combination,  allowing  the  escape 
cf  iodine  in  a  free  state,  but  it  has  certain  mechanical  proper- 
ties. When  the  surface  of  an  ulcer  or  wound  is  covered 
with  a  layer  of  iodoform  in  crystals,  a  certain  degree  of  ab- 
sorption of  the  fluids  secreted  takes  place.  These  products 
of  secretion  penetrating  the  interstices  between  the  minute 
crystals  of  iodoform  soon  lose  the  liquid  form,  and  produce 
with  them  an  impermeable  crust.  Under  this  crust,  cicatriza- 
tion soon  occurs,  without  any  retraction  of  the  tissues ;  hence 
they  suppose  that  the  best  form  in  which  to  employ  iodoform 
for  ulcers  and  wounds  is  that  of  the  crystals.  As  toxic  effects 
have  followed  the  internal  administration  of  iodoform,  it  should 
be  prescribed  with  care,  and  also  the  application  of  it  to  exten- 
sive surfaces  be  avoided.  The  toxic  symptoms  have  been 
manifested  as  follows,  the  maximum  dose  which  caused  them 
having  been  12^  grains: — 

"  Giddiness,  vomiting,  and  deep  sleep,  from  which  the  patient 
could  be  roused  with  difficulty.     The  somnolence  was  inter- 
15 


218 


DENTAL    MEDICINE. 


rupted  by  periods  of  excitement,  each  lasting  several  hours, 
and  was  followed  by  delirium,  intense  headache,  sense  of  im- 
pending death,  spasmodic  contractions  of  the  facial  muscles, 
and  in  the  case  of  the  younger  patient,  diplopia.  The  functions 
of  the  other  sensory  organs  were  not  disturbed,  and  the  pupils 
presented  a  normal  reaction.  Deep  inspirations  alternated 
with  apnoea  of  about  a  minute's  duration.  After  five  or  six 
days,  the  toxic  symptoms  gradually  lessened  and  passed 
away." 

Iodoform  has  been  used  for  odontalgia,  on  account  of  its 
gently  caustic  and  anodyne  action  on  exposed  pulps  of  teeth. 
Combined  with  arsenious  acid  and  creasote  in  a  devitalizing 
mixture,  iodoform  is  supposed  to  lessen  the  pain  caused  by  the 
arsenical  paste. 

DENTAL  FORMULA. 


For  an  Ointment  of  Iodofor7n  and 
Eucalyptus. 

R.     Pulv.  lodoformi ^^  ss 

Olei   Eucalypti fj5ss 

Vaselin .^  iv.      M. 

SiGNA. — To  be  used  as  an  ointment. 

For  Neuralgia  and  Tumors  of  the  Gums. 

R.     lodoformi gr.  xv 

Bals.  Peru gr.  xxx 

Glycerini  vel  Vaselin q.  s.       M. 

To  make  a  solution  or  ointment. 
SiGNA. — To  be  applied  as  a  solution ; 
or,  if  the  vaseline  is  used,  as  an  oint- 
ment. 

For  Odontalgia. 

(SCHAFF.) 

R.     Pulv.  lodoformi'. gr.  Ix 

Kaolin gr.  Ix 

Acidi  Carbolici gr.  viij 

Glycerini q.  s. 

Olei  Menthse  Piperit....gtt.'x.   M. 
Triturate   the   iodoform,  kaolin,  and 

oil  of  peppermint,  with  enough  glycerine 

to  form  a  thick  paste. 

SiGNA. — Apply  to  exposed  surface  of 
pulp. 


New   Methods  for   Deodorizing 
Iodoform. 

I. — Carbolic  Acid i  part 

Iodoform 2  parts. 

Powder  and  mix  well. 

No  change  appears  to  take  place  in 
the  iodoform,  but  the  odor  is  marked 
by  that  of  carbolic  acid. 

2. — Iodoform lOO  parts 

Oil  of  Peppermint 5  parts 

Oil  of  Neroli I  part 

Oil  of  Lemon 2  parts 

Tinct.  Benzoin 2  parts 

Acetic  Acid i  part. 

Powder  the  iodoform,  and  mix  tho- 
roughly with  the  other  ingredients. 
Transfer  to  a  well  stoppered  flask,  and 
•keep  at  a  temperature  of  from  120° 
F.  to  140°  F.,  over  a  water-bath  for 
two  days.  The  mixture  has  a  pleas- 
ant odor  of  Eau  de  Cologne. 

3. — Camphor 5  parts 

Charcoal 10  parts 

Iodoform 15  parts. 

Powder  and  mix  intimately. 


lODUM — IODINE. 


219 


For  Pulpitis,  as  a  Capping. 
Paschkis. 
U.     Iodoform,  pulv. 

Kaolin,  pulv aa gr.  Ix 

Acid.  Carbolic   (Cryst)..gr.  viij 
Mix,  and  add  sufficient    glycerin   to 
form  a  paste,  then  add : — 

01.  Menth.  pip gtt.  x. 

SiGNA. — Apply  on  point  of  broach  over 
inflamed  portion. 

For  Tumors.  Enlarged  Glands,  etc. 

U.     lodoformi part,  i 

Collodii part.  X.  M. 

SiGNA. — To  be  applied  as  a  lotion. 

For  Devitalizing  Pulps  of  Teeth. 

R  ,     lodoformi gr.  v 

Acidi  Arsenios gr.  x 

Creasoti q.  s.       M. 

To  make  a  paste. 
SiGNA. — ^Apply  on  cotton,  or  on  point 
of  a  broach. 


For  Pulpless  Teeth. 

R.     lodoformi gr.  x 

Acidi  Tannici gr.  iij 

Glycerini gtt.  xv.  M. 

SiGNA. — Apply    on    floss    silk,    or    by 

syringe. 
Preparation. — Rub  iodoform  to  fine 
powder  in  a  mortar,  and  add  the 
tannin,  and  after  mixing  thoroughly, 
add  the  glycerin.  One  drop  of  oil 
of  cinnamon  will  disguise  the  odor. 

For   Pulpless    Teeth    with    a    Fistulous 
Opening. 
Faught. 

R.     lodoformi ^  j 

Acidi  Tannici ^ij 

Glycerini f^ij 

Morphiae  Acetat ^j         M. 

Signa. — Apply  on  floss  silk. 


lODUM— IODINE. 
Fonnula,  I. 

Derivation.  Iodine  is  a  non-metallic,  metalloid  element, 
obtained  principally  from  kelp  (made  by  burning  seaweed 
and  in  the  form  of  impure  soda),  which  is  subjected  to  dis- 
tillation in  iron  retorts,  after  which  it  is  mixed  with  sulphuric 
acid  and  black  oxide  of  manganese.  It  is  evolved  in  the  form 
of  vapor,  which  is  condensed.  The  vapor  is  readily  recognized 
by  its  beautiful  violet  color.  Iodine  is  usually  in  the  form  of 
bluish-black  crystalline  scales,  with  a  metallic  lustre,  and  a 
strong,  peculiar  odor  and  a  hot,  acrid  taste.  It  is  slightly  sol- 
uble in  water  and  soluble  in  alcohol,  ether,  solution  of  chloride 
of  sodium,  and  a  solution  of  iodide  of  potassium. 

Medical  Properties  and  Action.  Iodine  in  small  doses  is 
alterative,  stimulant  and  tonic,  and  acts  locally  as  an  irritant, 
causing  redness,  itching  and  desquamation ;  exhaled  in  the 
form  of  vapor  it  excites  cough  and  warmth  in  the  air  passages. 
Taken  internally  it  excites  a  sensation  of  heat  or  burning  in 
the  stomach,  and  in  large  doses  is  an  irritant  poison,  inflaming 


220  DENTAL    MEDICINE. 


the  mucous  membrane  of  the  stomach  and  causing  superficial 
eschars.  The  internal  use  of  the  iodides  gives  rise  to  an 
eruption  of  acne,  especially  on  the  face,  thighs,  and  shoulders  ; 
they  have  also  anaphrodisiac  powers  when  long  continued. 
The  influence  of  the  iodides  in  producing  iodism  may  be 
prevented  by  large  draughts  of  water  being  used  during  their 
administration. 

The  odor  of  iodine  can  be  detected  in  the  blood,  brain, 
and  muscles. 

When  combined  with  potassium  its  local  irritant  effect  is 
diminished ;  hence  the  preparation  known  as  Iodide  of  Potas- 
sium, Potassii  lodidum  (obtained  by  treating  an  aqueous  solu- 
tion of  potassa  with  iodine),  is  employed  whenever  the  con- 
stitutional effects  of  iodine  are  desired,  as  the  iodide  of  potas- 
sium possesses  many  advantages  over  iodine  for  internal  use, 
such  as  being  less  irritant,  and  for  this  reason  may  be  adminis- 
tered in  larger  doses  and  for  a  greater  length  of  time ;  it  is 
also  more  soluble  than  iodine  alone,  and  when  taken  into  the 
stomach  is  absorbed  much  more  rapidly.  The  formula  is  KI, 
and  it  is  in  the  form  of  white  crystals,  of  an  acrid,  saline  taste. 
Some  persons  are  peculiarly  susceptible  to  the  influence  of 
iodine,  even  small  doses  causing  unpleasant  effects,  such  as 
headache,  vertigo,  derangement  of  the  digestive  organs,  etc. 

Iodide  of  potassium,  like  iodine,  produces  a  very  decided 
effect  on  the  secretions,  increasing  them,  and  occasionally  to 
the  degree  of  ptyalism.  The  antidote  for  poisoning  by  iodine 
is  starch. 

Therapeutic  Uses.  Iodine  and  its  preparations  are  valuable 
resolvents  in  the  treatment  of  glandular  enlargements,  indura- 
tions, tumors,  thickening  of  membranes,  etc.,  etc. ;  also  in 
scrofula,  scrofulous  ophthalmia,  tubercular  meningitis,  advanced 
stage  of  pleurisy,  chronic  affections  of  the  liver,  etc.,  etc. 

Iodide  of  potassium  is  much  employed  in  mercurial  poison- 
ing and  in  syphilis,  especially  in  the  secondary  and  tertiary 
forms,  and  after  the  employment  of  mercury  has  proved  use- 
less ;  also  in  affections  of  the  nervous  system  of  a  syphilitic 
origin,  together  with  the  other  affections  already  referred  to  as 


lODUM IODINE.  221 


indicating  iodine.  Externally  iodine  is  used  in  the  form  of 
tincture  in  the  treatment  of  enlarged  scrofulous  glands,  cu- 
taneous affections,  erysipelas,  rheumatism,  gout,  phlegmons, 
syphilitic  gummatae  and  nodes,  phagedaenic  ulcerations,  car- 
buncles, diseases  of  the  joints,  wounds,  and  parts  poisoned;  and 
as  a  counter-irritant  in  pneumonia,  phthisis,  and  pleurisy;  and 
as  injections  in  hydrocele,  and  bronchocele.  The  vapor  is  in- 
haled with  benefit  in  chronic  bronchitis  and  phthisis.  Iodine 
also  ranks  highly  as  a  disinfectant. 

Dose.  Of  iodine  alone,  gr.  y^  to  gr.  j  two  or  three  times 
a  day,  in  the  form  of  a  pill,  directly  after  eating,  on  account  of 
its  irritant  effect;  the  best  form  for  administration,  however,  is 
Iodide  of  Potassium.  Dose  of  the  iodide  of  potassium,  gr.  iij 
to  gr.  X. 

Tincture  of  Iodine — Tinctiira  lodi  (iodine,  5j  ;  alcohol,  Oj). 
Dose  ny'  to   yx\y. 

Compound  Tincture  of  Iodine — Tinctura  lodi  Composita 
(iodine,  Sss  ;  iodide  of  potassium,  Sj  ;  alcohol,  Oj).     Dose,  Tr\^ij 

to  Tl\^X. 

Dental  Uses.  In  dental  practice  iodine  and  its  preparations 
are  valuable  agents,  the  officinal  and  compound  tinctures  being 
employed  in  the  treatment  of  dental  periostitis,  alveolar  ab- 
scess, mercurial  stomatitis,  and  other  forms  of  stomatitis,  in- 
flammation and  ulceration  of  the  gums,  fungous  growths  of  gum 
and  tooth  pulp,  necrosed  teeth  and  suppurating  pulps  of  teeth, 
diseases  of  the  antrum,  caries  of  maxillary  bones,  dentigerous 
cysts,  recession  of  gums  and  absorption  of  alveolar  processes. 

For  the  different  forms  of  stomatitis,  and  especially  mercu- 
rial stomatitis,  the  tincture  of  iodine  is  used  in  the  form  of  a 
gargle  ;  for  an  injection  in  alveolar  abscess  it  is  diluted  or  com- 
bined with  carbolic  acid,  glycerine  and  other  agents  ;  for  fun- 
gous growths  it  may  be  used  alone,  or  combined  with  rectified 
alcohol ;  for  ulcerations  of  gum  and  mucous  membrane  it  is 
generally  combined  with  carbolic  acid  ;  for  dental  periostitis  it 
is  combined  with  the  tincture  of  aconite  root,  and  is  regarded 
as  being  almost  a  specific  for  the  incipient  stages  of  this  affec- 
tion.    Either  the  officinal  or  compound  tincture   is  employed 


222  DENTAL    MEDICINE. 

with  an  equal  quantity  of  the  tincture  of  aconite,  the  prepara- 
tion being  apphed  to  the  gum  over  root  of  affected  tooth,  which 
should  be  previously  dried  of  moisture,  by  means  of  a  camels'- 
hair  brush  or  cotton  on  the  point  of  an  excavator.  The  mouth 
should  be  kept  open  and  the  part  protected  until  a  metallic 
pellicle  is  formed. 

A  valuable  combination  of  iodine,  carbolic  acid,  glycerin 
and  water  is  known  as  "  Boulton's  Preparation,"  and  is  a  useful 
application  in  the  form  of  injections,  gargles  and  lotions.  For 
the  chronic  form  of  alveolar  abscess,  and  also  for  the  acute 
form,  after  more  powerful  agents  have  been  employed,  it  is  a 
useful  remedy,  possessing  antiseptic  and  stimulant  properties 
in  a  marked  degree ;  it  also  possesses  the  property  of  modify- 
ing mucous  membrane  and  diminishing  sensibility  ;  hence  it  is 
useful  in  ulcerations,  etc.  Tincture  of  iodine  combined  with 
creasote  or  carbolic  acid  is  a  powerful  application  in  dental 
periostitis,  suppuration  of  necrosed  teeth,  ulceration  of  margins 
of  the  gums,  and  for  fungous  growths,  as  it  stimulates  debilitated 
parts  and  destroys  such  as  are  too  weak  to  be  restored.  A 
colorless  tincture  of  iodine  is  composed  of  glycerin  and  aqua 
ammonia  in  combination  with  the  iodine,  but  the  presence  of 
the  ammonia  restricts  its  use.  Another  colorless  tincture,  in 
which  sulphate  of  soda  is  substituted  for  the  ammonia,  is  less 
irritating  in  its  effects. 

The  addition  of  water  and  honey  to  the  officinal  tincture 
of  iodine  will  render  it  suitable  for  a  gargle  for  inflamed  and 
ulcerated  parts.  The  iodide  of  potassium  is  employed  inter- 
nally in  mercurial  stomatitis,  dental  exostosis,  facial  neuralgia, 
convulsions  of  dentition,  dental  periostitis,  looseness  of  the 
teeth,  tumefaction  and  sponginess  of  the  gums,  syphilitic  and 
scrofulous  ulcerations  of  the  mouth,  caries  and  necrosis  of  the 

maxillary  bones. 

DENTAL  FORMULAE. 

For  Fungous  Growths  a7id  Suppurating  For  Ulcerated  Gu7ns  and  Mucous 

Surfaces.  Membrane. 

K.     Tinct.  lodi ^ij  R.     Tinct.  lodi partem  j 

Spirit!  Rectificati gj.     M.  Mellis partes  ij 

SiGNA.— To  be  applied  with  a  camel's  Aqute partes  vij.  M. 

hair  brush.  SiGNA. — To  be  used  as  a  gargle. 


IRIDIS    RHIZOME ORRIS    RHIZOME ORRIS    ROOT. 


223 


For  Chronic  Alveolar  Abscess,  Ulcera- 
tions, Inflammations,  etc.,  etc. 

(BOULTON.) 

R.     Tinct.  lodi.  Comp l^xlv 

Acidi  Carbolic!  (Cryst)....rr\^vj 

GlyceriiiEe 5  j 

Aquee  Destillatte ^  v.   M. 

It  becomes  colorless  in  from  8  to  10 
hours. 

SiGNA. — To  be  used  as  an  injection, 
gargle  or  lotion. 

For  Mercurial  Stomatitis. 

R.     Tinct.  lodi .^^iij  vel  vj 

Potassii  Iodidi...gr.  xv  vel  xxx 
Aquae Oss.  M. 

SiGNA. — To  be  used  as  a  gargle. 

For  Ulceration  of  Gums. 

R.     Tinct.  lodi Tr\^xlv 

Acidi  Carbolici n\^vj 

Glycerinse ^  j 

Aquaa  Destillatas _^v.       M. 

SiGNA. — Apply  as  a  lotion. 

For  Dental  Periostitis. 

R.     Tinct.  lodi ^j 

Creasoti  vel 

Acidi  Carbolici ^ss.     M. 

SiGNA. — To  be   applied  to  gum  about 
neck  of  tooth,  as  a  counter-irritant. 


For  Dental  Periostitis. 

R.     Tinct.  lodi ^^x 

Potassii  lodidi f^  ss 

Camphorse ^^ij 

Spirit!  Rectificati f.l'^-    M- 

SiGNA. — Apply  with  a  camel's  hair  brush 
to  gum  over  root  of  affected  tooth. 

For  Dental  Periostitis. 

R.     Tinct.  lodi 

Tmct.  Aconiti aa ^ss.      M. 

SiGNA. — To  be  applied  by  means  of  a 
camel's  hair  brush  until  a  metallic 
pellicle  is  formed,  three  times  daily. 

For  Excessive  Siveating  of  the  Hands. 

R.     Tinct.  lodi gj 

Lin.  Camphorse  Comp. 

Glycerinae aa ^iss 

Lin.  Belladonna  Comp.^^  j 

Eau  de  Cologne ^^j.        M. 

SiGNA. — Apply  as  an  embrocation  twice 
a  day,  having  previously  well  bathed 
the  hands  in  warm  water,  in  which 
is  dissolved  two  drachms  or  half  an 
ounce  of  chloride  of  ammonia  and 
four  drachms  of  carbonate  of  soda, 
crystals,  enough  water  being  used  to 
well  cover  the  hands. 


IRIDIS  RHIZOME-ORRIS  RHIZOME-ORRIS  ROOT. 

Source.  The  plant  from  which  orris  root  is  obtained  is  a 
native  of  Italy  and  the  south  of  Europe.  It  belongs  to  the 
natural  order  Iridaceae,  of  which  there  are  three  varieties  of 
the  species  of  Iris — Iris  RJiizonia,  Iris  Florentina  and  Iris  Ger- 
manica.  The  root,  which  is  the  officinal  portion  of  the  plant, 
is  of  various  forms  and  sizes,  often  branched,  usually  knotty 
and  flattened,  white,  heavy,  and  of  the  thickness  of  the  finger. 
It  has  a  pleasant  odor,  like  that  of  violet,  and  a  bitter,  acrid 
taste. 

Medical  Properties  mid  Action.     Orris  root  is  cathartic  and 


224  DENTAL    MEDICINE. 


diuretic,  and  in  large  doses  emetic.  It  has  been  employed 
with  some  benefit  in  dropsies,  but  is  not  often  administered 
as  a  general  remedy  at  the  present  time.  It  is  valued  for  its 
pleasant,  violet  odor. 

Dental  Uses.  In  dental  practice  it  is  employed  as  a  very 
common  ingredient  of  dentifrices,  and  also  to  correct  an 
offensive  breath. 

ISONANDRA  GUTTA— GUTTA  PERCHA. 

Source.  Gutta  Percha  is  the  inspissated  juice  of  the  tree 
Isonandra  Gutta,  extensive  forests  of  which  are  found  in  the 
East  Indies.  It  belongs  to  the  natural  order  SapotacecE.  It  is 
in  the  form  of  tough,  flexible  pieces,  which  have  been  freed 
from  impurities  by  cutting  it  into  thin  slices,  and  then  washing 
and  tearing  it  into  shreds  by  heavy  machinery  while  it  is  soft- 
ened in  boiling  water.  It  may  be  more  thoroughly  purified  by 
dissolving  it  in  either  chloroform,  benzol  or  hot  turpentine, 
thus  causing  the  impurities  to  separate,  when  it  is  evaporated 
to  dryness.  Crude  gutta  percha  is  of  a  chocolate  or  red  dish- 
brown  color ;  commercial  gutta  percha  is  of  a  grayish-white 
color,  and  the  variety  which  has  been  purified  by  dissolving  it 
in  chloroform,  etc.,  is  almost  white,  greasy  to  the  touch,  and  of  a 
leathery  smell,  like  that  of  india  rubber.  It  is  insoluble  in  water 
at  any  temperature,  and  is  a  bad  conductor  of  heat  and  elec- 
tricity. At  ordinary  temperatures  it  is  tough,  hard  and  inelastic, 
but  towards  120°  F.  it  softens,  and  at  150°  it  becomes  soft  and 
plastic,  and  may  be  moulded  into  any  form,  which  it  will  retain 
on  cooling,  having,  however,  a  perceptible  shrinkage.  Gutta 
percha  is  dissolved  cold  by  chloroform  and  sulphide  of  carbon  ; 
benzol  requires  the  aid  of  heat  and  oil  of  turpentine  requires 
to  be  quite  hot.  The  alkalies  have  no  action  upon  it;  but  con- 
centrated nitric  acid  attacks  it  rapidly,  with  effervescence  and 
the  escape  of  nitrous  fumes. 

Dental  Uses.  Combined  with  mineral  substances  it  forms  a 
plastic  material  for  temporary  fillings  of  teeth,  and,  colored 
with  Vermillion,  is  used  for  taking  impressions  of  the  mouth 
and  for  the  base  plates  of  plastic  work.     It  is  often  employed 


KRAMERIA KRAMERIA.  225 

as  a  filling  material,  on  account  of  its  non-conducting  property, 
protecting  a  partially-exposed  pulp  or  sensitive  dentinal  surface 
from  irritation  when  metallic  fillings   would  not  be  tolerated. 

The  preparation  known  as  "  Hill's  Stopping,"  is  composed 
ofgutta  percha,  quick-lime  and  feldspar,  the  mineral  ingredi- 
ents being  incorporated  with  the  gutta  percha  while  the  latter 
is  in  a  plastic  condition  from  the  effects  of  heat.  Gutta  percha 
has  been  used  for  interdental  splints. 

Solution  of  Gutta  Pcrclia — Liquor  Gutta  Percha,  is  composed 
of  gutta  percha,  Siss ;  chloroform,  5xvij  ;  or  a  thick  solution 
may  be  made  by  dissolving  as  much  gutta  percha  in  chloro- 
form as  will  give  the  desired  consistence  (like  that  of  thick 
cream). 

Solution  of  gutta  percha  is  a  useful  application  for  the  relief 
of  odontalgia  arising  from  an  exposed  and  inflamed  pulp  ;  also 
for  capping  an  exposed  pulp,  a  more  durable  material  being 
inserted  over  it.  The  chloroform  of  the  solution  quickly  evap- 
orates, leaving  an  impermeable  covering  of  the  gutta  percha, 
which  is  non-irritable,  non-conducting  and  protective.  It  is 
also  a  useful  application  for  inflamed  or  abraded  surfaces, 
chaps,  skin  affections,  etc. 

KRAMERIA— KRAMERIA. 

Rhatany. 

Source.  Krameria  is  obtained  from  the  root  of  the  shrub 
krameria  triandra,  of  the  natural  order  PolygalecB,  native  of 
Peru.  It  is  in  the  form  of  cylindrical  pieces,  of  the  thickness 
of  a  quill,  with  many  branches  of  a  light  red  color  within  and 
crossed  by  a  reddish-brown  bark.  The  root  is  without  odor, 
and  of  an  astringent,  and  somewhat  bitter  sweetish  taste. 

Medical  Properties  and  Action.  Krameria  is  a  powerful  as- 
tringent, its  medicinal  property  being  due  to  tannic  acid,  of 
which  it  contains  about  forty  per  cent.  There  is  also  present 
an  odorous  principle,  wax  gum,  and  a  peculiar  acid  known  as 
kraineric  acid.  When  chewed  it  imparts  a  red  tinge  to  the 
saliva.  It  imparts  its  properties  very  readily  to  alcohol,  but 
less  so  to  both  cold  and  boilino;  water. 


226  DENTAL    MEDICINE. 


TJierapeutic  Uses.  Krameria  is  employed  internally  for  its 
astringent  and  a  slightly  tonic  effect  in  the  treatment  of  diar- 
rhoea, dysentery,  passive  hemorrhages,  menorrhagia,  leucor- 
rhoea,  etc.  Externally,  in  the  form  of  powder,  tincture  and 
infusion,  in  the  treatment  of  ozsena,  ophthalmia,  etc.,  and  as  an 
enema  in  hemorrhoids,  fissures  of  the  anus,  sore  nipples,  leu- 
corrhoea,  etc.,  etc. 

Dose.  Of  powdered  krameria,  gr.  xx  to  gr.  xxx ;  of  the  ex- 
tract— extractuni  kramericB,  the  dose  is  gr.  v  to  gr.  x  ;  of  the 
infusion — infusum  kranierice  (krameriae,  5J ;  water,  Oj) ;  the  dose 
is  Sss  to  5J  ;  of  the  tincture — tinctura  kramerice  (krameriae,  ovj  ; 
diluted  alcohol,  Oij),  the  dose  is  5j  to  5ij.  Of  the  fluid  ex- 
tract— extractum  kramericB  fluidmn,  the  dose  is  tt^v  to  5ss ;  of 
the  syrup — syrupus  krameri(E,  the  dose  is  5j  to  5iv. 

Dental  Uses.  Krameria  is  a  valuable  astringent  in  dental 
practice,  being  employed  in  the  form  of  the  tincture  in  ulcer- 
ated and  spongy  gums;  in  the  form  of  the  infusion  as  a  gargle 
in  inflammation  of  the  gums  and  mucous  membrane;  in  the 
form  of  the  powder  and  also  tincture,  in  spongy  and  bleeding 
gums,  as  an  astringent;  and  also  in  the  form  of  the  powder  as 
an  ingredient  of  dentifrices,  for  its  astringent  property. 

DENTAL  FORMULA. 
For  Inflamed  Gums  and  Mucous  Membrane. 

(THOMAS.) 

R  •    Pulv.  Krameriae. 

Pulv.  Cinnamomi...aa..  3J 

Aquee  Bullientis {"^m]. 

Macerate  for  two  hours,  strain,  and  add 
sacchari  ^^  ij.  M. 

SiGNA.     To  be  used  as  a  gargle. 

LIQUOR    SOD^    CHLORATE— SOLUTION   OF 
CHLORINATED  SODA. 

Labarraque's  Solution. 

Formula.     NaCl,  NaClO. 

Derivation.  Solution  of  Chlorinated  Soda  is  obtained  by 
decomposing  a  solution  of  carbonate  of  sodium  by  one  of 
chlorinated   lime.      It   is   a  transparent  liquid,  of  a   greenish- 


SOLUTION    OF    CHLORINATED    SODA.  227 

yellow  color,  having  a  faint  odor  of  chlorine  and  a  sharp  saline 
taste. 

Medical  PropcTtics  and  Action.  Solution  of  chlorinated  soda 
internally  is  stimulant,  tonic  and  antiseptic.  Externally,  it  is 
a  stimulant,  astringent  and  deodorizer,  and  is  generally  applied 
in  the  form  of  a  lotion. 

Therapeutic  Uses.  Solution  of  chlorinated  soda  is  em- 
ployed internally  in  typhus  and  typhoid  and  malignant"  scarlet 
fevers,  mesenteric  affections  of  children,  etc.  Externally  it  is 
used  as  an  application  to  all  forms  of  foul  and  indolent  ulcers, 
ulcerations  of  membranes,  ozsena,  coryza,  otorrhoea,  syphilitic 
eruptions  of  scalp  and  other  skin  diseases,  burns,  etc.,  etc.  It 
is  used  diluted,  and  has  an  alkaline  reaction.  It  is  a  power- 
ful disinfectant,  and  is  useful  in  all  affections  attended 
with  fetor.  The  concentrated  solution  is  an  irritant  poison  and 
caustic ;  largely  diluted  it  is  tonic  and  stimulant. 

Dose.  Of  solution  of  chlorinated  soda,  gtt.  xxx  to  5j,  di- 
luted, several  times  a  day ;  it  fulfills  the  same  indications  as 
chlorinated  lime. 

Dental  Uses.  Solution  of  chlorinated  soda  is  a  valuable 
agent  in  dental  practice  as  a  disinfectant,  deodorizer  and  anti- 
septic. It  is  employed  in  mercurial  stomatitis,  ulcerated  gums, 
fetid  discharges  from  carious  teeth,  and  all  affections  of  the 
mouth  attended  with  fetid  discharge,  and  is  useful  for  its  stimu- 
lating property,  thus  inducing  healthy  action  ;  also  in  aphthae, 
cancrum  oris,  diseases  of  the  antrum,  necrosis  of  the  bones  of 
the  jaws,  scurvy,  offensive  breath,  and  as  a  bleaching  agent  for 
discolored  teeth.  It  should  be  kept  in  glass-stoppered  bottles 
and  protected  from  the  light  and  heat. 

DENTAL  FORMULA. 

For  Aphtha  and  Ulceration  of  the  For   Alercurial  Stomatitis,  Fetid  Dis- 

Mouths  of  Children.  charges  from    Carious    Teeth,  Ulcer- 

R  .     Liquor  Soda  Chlor.,  ated  Gutns,  etc. 

Myrrhae aa ^^ss  R.     Liquor  Sodse  Chlor.... f^^vj 

AquEe  Rosse f  ^5  j  Aquae f§-^ij       ^■ 

Aquae ^5^]-     M.  SiGNA. — To  be  used  as  a  lotion, 

SiGNA. — To  be  used  as  a  lotion. 


228  DENTAL    MEDICINE. 


For  Offensive  Breath  and  Deodorizer  For  Mercurial  Stomatitis. 

Generally.  R.     Liquor  Sodse  Chlor ^^  ss 

R.     Liquor     Sodae      Chlor.  Mellis gss 

(concent) gtt.  vj  to  x  Aquae  Destillatse ^x.         M. 

Aquae  Purae 5  ij.       M.  SiGNA. — To  be  used  as  a  mouth  wash. 

SiGNA. — To  be  used  as  a  gargle. 

For  Phagedenic  and  Sloughing  Ulcers. 

For  Offensive  Breath.  R.     Liquor  Sodse  Chlor.... f^^j 

R.     Liquor  Sodas  Chlor ^j  Aquje f_^  viij.     M. 

Aquae ,^iv.     M.  Signa. — To  be  applied  as  a  lotion. 

SiGNA. — To  be  used  as  a  gargle. 

LITMUS— LACMUS. 

Source.  Litmus  is  a  peculiar  coloring  matter  obtained  from 
various  species  of  rocella,  of  the  natural  order  Lichcncs — the 
Lichen  order,  which  grow  on  Alpine  or  maritime  rocks  in 
various  parts  of  the  world.  The  varieties  used  for  chemical 
purposes  are  obtained  from  the  European  and  African  coasts 
and  northern  Europe.  They  yield  coloring  substances  by 
the  reaction  of  water,  air,  and  ammonia.  Litmus  is  prepared 
chiefly  in  Holland ;  the  lichens  being  coarsely  powdered  and 
macerated  for  several  weeks,  with  occasional  agitation  in  a 
mixture  of  urine,  lime  and  potassa  or  soda,  fermentation  en- 
suing ;  the  mass  becomes  first  red  and  ultimately  blue,  and  is 
then  mixed  with  calcareous  or  siliceous  matter,  to  give  it  con- 
sistence. A  tincture  is  formed  from  this  product  (litmus  i  part 
to  distilled  water  20  parts),  and  blue  litmus  paper  is  made  by 
steeping  unsized  paper  in  the  liquid  and  afterwards  drying  it. 
The  blue  tincture  is  rendered  deeper  in  color  by  indigo.  Red 
litmus  paper  is  prepared  in  the  same  manner,  except  that  the 
tincture,  into  which  the  unsized  paper  is  steeped,  is  reddened 
by  the  addition  of  sulphuric  acid. 

Use.  The  chief  use  of  litmus  in  medicine  and  dentistry  is 
as  a  test  of  acids  and  alkalies ;  blue  litmus  paper  being  turned 
red  by  acids,  while  red  litmus  paper  is  turned  blue  by  alkalies. 
In  dental  practice  litmus  paper  is  employed  to  determine  the 
nature  of  the  oral  fluids — whether  acid  or  alkaline. 

A  single  color,  viz.,  purple,  has  recently  been  substituted 
for  the   ordinary  blue   and    red    litmus    paper.     This    purple 


MAGNESIA CALCINED    MAGNESIA.  229 

litmus  paper  turns  red  with  acids,  blue  with  alkalies.     It  is 
claimed  to  be  much  more  delicate  and  convenient. 

MAGNESIA— CALCINED    MAGNESIA. 

Formula,  MgO. 

Derivation.  Magnesia  is  obtained  by  exposing  carbonate  of 
magnesium  to  a  red  heat,  and  thus  expelling  all  of  the  car- 
bonic acid,  which  is  shown  by  a  want  of  effervescence  on  the 
addition  of  dilute  sulphuric  acid.  It  is  very  light,  and  of  white 
color  and  odorless,  and  in  the  form  of  powder,  with  an  earthy 
taste,  and  slightly  soluble  in  water,  more  so  in  cold  than  in 
hot  water. 

Medical  Properties  and  Action.  Magnesia  is  antacid  and 
laxative,  its  laxative  effect  being  the  result  of  the  combination 
it  forms  with  the  free  acids  of  the  stomach  and  intestines. 
After  its  effects  are  exerted  in  the  intestinal  canal,  it  becomes 
absorbed,  and  renders  the  urine  alkaline.  Large  doses,  Avhen 
administered  for  a  considerable  time,  may  accumulate  in  the 
bowels ;  such  an  effect  may  be  obviated  by  administering  it 
with  lemonade,  which  renders  it  more  soluble.  Being  mild 
and  unirritating,  it  is  well  adapted  for  children,  and  is  an  ex- 
cellent remedy  for  great  acidity  in  the  stomach.  It  is  the 
antidote  in  poisoning  by  the  mineral  acids. 

Therapeutic  Uses.  Magnesia  is  administered  in  acidity  of 
the  stomach,  heartburn,  sick  headache  and  kidney  affections, 
as  an  antacid,  and  in  combination  with  other  agents  in  the 
diarrhoea  of  children.  It  is  also  an  efficient  aperient,  alone  or 
in  a  little  milk. 

Dose.  Of  Magnesia,  as  a  laxative,  gr.  x  to  5j ;  as  an  antacid, 
I3j.  Of  a  preparation  known  as  "  Henry's,"  the  dose  is  half 
the  quantity  just  given. 

Dental  Uses.  Magnesia  is  employed  in  dental  practice, 
chiefly  for  its  antacid  properties,  as  an  ingredient  of  denti- 
frices ;  in  solution  in  the  form  of  a  gargle,  to  counteract  the 
effects  of  acid  medicines  upon  the  teeth ;  also  as  an  ingredient 
of  remedies  for  infantile  diarrhoea  during  the  period  of  den- 
tition ;  and  also  to  change  an  acid  condition  of  the  oral  fluids. 


230  DENTAL    MEDICINE. 


by  being  rubbed  between  the  teeth  and  permitted  to  remain 
for  a  short  time. 

DENTAL  FORMULA. 

For  hifantile  Biliotis  Diarrhoea.  For  Infantile  Mucous  Diarrhoea. 

CONDIE.  EhERLE. 

R.     Magnesise  Calc gr.  xxiv  R.     Magnesise  Calc gr- x 

Calomel gr.  ij-iij  Bals.  Copaibae ^j 

Ipecacuanha gr.  ij-iij  Spir.  ^ther  Nit ^iij 

Ext.  Hyoscyami gr.iv-vj.M.  Sacch.  Alb 3  ij 

F.  ch.  No.  xij.  Aq.  Cinnamon ^iij.      M. 

SiGNA. — One  to  be  given  every  two  or     Signa. — A   teaspoonful    every   two   or 
three  hours.  three  hours;  each  dose  to  be  followed 

in  the  course  of  an  hour  by  the  fifth 
of  a  grain  of  Dover's  powder. 

MAGNESII  SULPHAS— SULPHATE  OF  MAGNESIUM. 
(Epsom  Salt.) 

Formula,  MgS04  7H2O. 

Derivation.  Epsom  salt  is  obtained  by  the  action  of  sul- 
phuric acid  on  inagnesite,  the  silicious  hydrate  of  magnesium. 
It  is  in  the  form  of  small  colorless  crystals,  which  effloresce  on 
exposure  to  the  air,  and  are  very  soluble  in  water.  It  is  odor- 
less, but  has  a  very  bitter  taste. 

Medical  Properties  and  Action.  Sulphate  of  magnesia  is  a 
refrigerant  purgative,  safe  and  mild  in  its  action,  and  is  per- 
haps more  commonly  employed  as  a  cathartic  than  any  other. 
It  is  at  .times  combined  with  other  agents. 

Therapeutic  Uses.  Sulphate  of  magnesia  is  administered  as 
a  saline  purgative  in  acute  inflammatory  and  febrile  affections, 
to  depress  the  arterial  tension,  and  also  to  relieve  the  kidneys 
where  they  are  hyperaemic,  hence  it  is  a  valuable  remedy 
in  renal  and  cardiac  dropsy,  constipation  of  lead  colic,  acute 
dysentery,  dyspepsia  with  constipation,  etc.,  etc. 

Dose.  Of  Sulphate  of  Magnesia  5j  to  Sj,  in  water  or  car- 
bonic acid  water. 

Dental  Uses.  Sulphate  of  magnesia  is  employed  in  dental 
practice,  to  reduce  the  arterial  tension  in  acute  inflammations 
of  the  dental  organs,  such  as  acute  pulpitis,  acute  periostitis, 
etc. 


MATICO MATICO.  231 


To  disguise  the  bitter  taste  of  Epsom  salts  the  following 
formula  may  be  employed  : — 

R.     Magnesii  Sulphatis ^v 

Essentiae  Menthse gtt.  iij.     M. 

DENTAL  FORMULA. 
For  Dysuria  of  Diffladt  Dentition. 

R.     Sulph.  Magnes ^^ij  to  5  iij 

Aquae  Purae _^  j  dein  adde 

Spir.  ^ther.  Nitrici..  5  ij 

Tinct.  Opii Tr\^vij  to  xv.   M. 

SiGNA. — A  teaspoonful,  to  be  repeated 
according  to  circumstances. 

MATICO— MATICO. 

Source.  Matico — inaticce  folice,  are  the  dried  leaves  of  the 
shrub  artanthe  elongata,  of  the  natural  order  PiperacccE — pep- 
per order,  and  is  a  native  of  Peru.  They  are  from  two  to 
eight  inches  long  by  an  inch  in  breadth,  strongly  reticulated, 
and  of  a  bright  green  on  the  upper  surface  and  lighter  in  color 
beneath  when  fresh,  with  an  agreeable  aromatic  odor  and  a 
strong  astringent  taste.  They,  contain  a  trace  of  tannic  acid,  a 
peculiar  acid  artantliic,  a  volatile  oil,  resin,  and  a  very  bitter 
principle — iiiaticin. 

Medical  Properties  and  Action.  Matico  is  an  aromatic  tonic, 
an  alterative  stimulant  and  internal  haemostatic  and  local  styp- 
tic. It  has  a  special  determination  to  the  mucous  membranes, 
and  although  as  an  internal  remedy  its  astringent  properties 
are  not  so  well  marked,  it  acts  externally  as  a  reli- 
able haemostatic  and  styptic.  The  powder  made  from  the 
under  side  of  the  leaf  is  more  powerfully  styptic  than  that  from 
the  upper  side. 

Therapeutic  Uses.  Matico  in  the  form  of  powder,  infusion 
and  fluid  extract,  is  employed  in  internal  hemorrhages,  epis- 
taxis,  atonic  diarrhoea  and  diseases  of  the  urinary  passages, 
etc.;  externally  as  a  haemostatic  in  superficial  hemorrhages., 
and  also  in  leucorrhoea,  in  the  form  of  an  injection. 

Dose.     Of  powdered  Matico,  oss  to  5j,  three  times  a  day  ; 


232  DENTAL    MEDICINE. 


of  the  infusion  the  dose  is  foij  ;  of  the  fluid  extract  the   dose 
is  foss  to  f5j. 

Dental  Uses.  The  powder  and  tincture  are  valuable  styptic's 
in  hemorrhage  following  the  extraction  of  teeth,  hemorrhage 
from  leech  bites  and  superficial  wounds  of  mucous  membrane. 

MENTHOL— JAPANESE   CAMPHOR. 

(Peppermint  Camphor). 

Formula,  C10H20O. 

Derivation.  Menthol  is  the  stearoptene  of  peppermint  oil, 
and  is  obtained  from  this  oil  either  by  long  keeping  or  by 
being  cooled  at  a  low  temperature.  Chemically,  menthol 
occupies  the  position  of  an  alcohol,  having  in  its  composition 
four  atoms  more  of  hydrogen  than  the  ordinary  camphor  and 
containing  the  radical  menthyl.  It  is  in  the  form  of  a  crystal- 
line solid,  composed  of  small  white  crystals  of  a  peppermint 
odor  and  resembling  sulphate  of  magnesia.  It  is  imported  as 
Japanese  camphor,  its  chief  source  being  the  Japanese  and 
Chinese  peppermint  oils.  In  a  liquid  state  it  has  a  specific 
gravity  less  than  that  of  water.  It  is  rendered  liquid  and 
volatile  at  a  temperature  one  or  two  degrees  below  that  of  the 
body.  It  is  sparingly  soluble  in  cold  water,  liquefying  slowly 
in  water  at  82°  F.,  quickly  at  120°  F.,  but  remains  mostly  as 
a  separate  body.  It  is  freely  soluble  in  alcohol,  ether,  glycer- 
ine, and  in  the  fixed  and  volatile  oils. 

Medical  Properties  and  Action.  Menthol  is  anodyne,  anti- 
spasmodic, and  antiseptic.  In  doses  of  gr.  ^^  to  \  it  steadies 
the  contractions  of  an  excited  heart,  and  causes  tranquillity, 
and  at  the  same  time  slight  cerebral  drowsiness. 

Half  a  grain  may  cause  vomiting,  from  gastric  irritation ; 
hence  care  should  be  observed  in  its  administration,  either 
internally  or  externally,  about  the  mouth.  Its  internal  use  is 
not  advocated,  unless  well  diluted,  but  its  principal  use  is  as 
an  external  application. 

Therapeutic  Uses.  Menthol  is  said  to  prove  as  effectual  as 
aconite,  veratria  and  atropine,  for  such  diseases  as  neuralgia 


METHYLIC  ETHER METHYL-ETHYLIC  ETHER.      233 

brachialgia  and  gout;  more  so,  it  is  claimed  by  some.     It  is 
also  applied  to  putrefactive  wounds,  as  an  antiseptic. 

Dental  Uses.  In  dental  practice  menthol  has  given  satis- 
faction as  an  external  remedy  in  facial  neuralgia,  odontalgia, 
as  an  obtunder  of  sensitive  dentine,  and  as  a  local  anaesthetic. 
For  relieving  the  pain  of  sensitive  dentine  a  small  portion  of 
the  crystals  is  applied  to  the  sensitive  surface,  and  in  a  few- 
minutes  the  local  anaesthetic  effect  is  produced.  As  an  anti- 
septic it  has  been  employed  in  the  treatment  of  decomposing 
pulps  of  teeth,  necrosed  teeth,  etc. 

DENTAL  FORMULA, 

For  Facial  Neuralgia  and  Odontalgia. 
R.     Menthol gr.  j 

Spts.  Vini  Rectificati TTLJ 

Olei  Caryophilli rr^x.     M. 

SiGNA. — F'or  facial  neuralgia,  painted  on 
the  affected  part.  For  odontalgia,  ap- 
plied on  cotton  to  carious  cavity. 

METHYLIC    ETHER— METHYL-ETHYLIC    ETHER. 

Formula.     (CH2)  2O. 

DeiHvatioji.  Methylic  Ether  is  obtained  by  digesting  methy- 
lic  alcohol  with  strong  sulphuric  acid.  It  is  a  gaseous  subr 
stance,  of  an  ethereal  odor,  and  under  the  name  of  methyl-ethylic 
ether,  it  has  been  used  as  a  general  anaesthetic.  The  methylic 
ether  is  prepared  for  use  as  methyl-ethylic  ether  by  frequent 
washings  in  a  strong  solution  of  potassa,  and  is  afterwards  dis- 
solved in  absolute  ethylic  ether.  In  order  that  it  may  be  fit 
for  use,  it  is  necessary  to  keep  it  for  some  time  securely 
stopped. 

Dental  Uses.  According  to  Dr.  B.  W.  Richardson,  of  Eng- 
land, it  is  a  superior  anaesthetic  for  dental  operations — better, 
he  says,  than  nitrous  oxide  gas,  because  it  allows  air  to  be 
given  with  it,  and  does  not  asphyxiate  nor  produce  muscular 
spasms  and  syncope.  Under  its  influence  the  patient  is  in  a 
state  of  semi-consciousness,  but  is  not  conscious  of  pain  from 
an  operation. 
16 


234  DENTAL   MEDICINE. 


MORPHINA— MORPHINE. 

Formula.     C17H19NO3,  H2O. 

Derivation.  Morphine  is  the  alkaloid  which  constitutes 
the  chief  narcotic  principle  of  opium,  the  proportion  varying 
from  10  to  15  per  cent.  It  is  present  in  opium  in  combination 
with  meconic  acid,  and  the  meconate  of  morphia  is  separated 
by  repeated  macerations  with  water,  after  which  the  salt  is  de- 
composed by  alcohol  and  water  of  ammonia,  the  latter  precipi- 
tating the  morphine  and  the  former  taking  up  the  coloring 
matter  as  soon  as  it  is  freed  from  the  alkali.  The  crystals  of 
morphine  are  then  boiled  in  alcohol  and  the  solution  filtered 
through  animal  charcoal.  Morphine  is  in  the  form  of  white 
or  colorless  crystals,  which  are  inflammable  and  freely  soluble 
in  boiling  alcohol,  scarcely  soluble  in  cold  water,  and  some- 
what so  in  boiling  water ;  the  salts  of  morphine,  however,  are 
freely  soluble  in  water.  It  is  without  odor,  and  has  a  very 
bitter  taste.  Morphine  differs  somewhat  in  its  mode  of  action 
from  opium,  which  may  arise  from  the  peculiar  state  of  com- 
bination in  which  it  exists  in  opium.  Morphine  is  more 
insoluble  than  its  salts,  and  for  this  reason  the  latter  are 
preferred  for  administration. 

Medical  Properties  and  Action.  Morphine  is  more  powerful 
than  opium ;  but  it  causes  less  vascular  and  arterial  excite- 
ment, less  headache  and  vertigo,  less  subsequent  depression, 
less  constipation,  and  often  it  will  be  retained  on  an  irritable 
stomach  when  opium  or  its  tincture  (laudanum)  would  be 
rejected. 

Morphine  is  indicated  when  the  object  is  to  relieve  nervous 
irritability  and  induce  tranquillity.  The  effects  of  morphine 
differ  according  to  the  peculiarities  of  nervous  constitution. 
The  hypnotic  effect  may  be  produced  and  the  stimulant  action 
be  confined  to  the  heart ;  in  some  cases  the  excitant  effect  pre- 
vails, or  the  two  effects  may  be  equal.  The  excitant  effect 
may  counteract  the  hypnotic  effect  to  a  greater  or  less  degree, 
resulting  in  insomnia,  with  restlessness,  or  even  delirium. 
Females  appear  to  be  more  liable  to  its  excitant  effects  than 


MORPHINA MORPHINE.  235 

males  ;  and  if  there  is  present  a  highly  emotional,  excitable  and 
energetic  temperament,  it  causes  great  distress,  and  dangerous 
effects  when  hypodermically  administered. 

Therapeutic  Uses.  Morphine,  in  the  form  of  salts,  is  em- 
ployed as  an  anodyne  and  hypnotic  in  neuralgic  affections, 
diseases  of  the  heart,  painful  uterine  affections,  and  in  all  cases 
of  painful  affections.     (See  Opium.) 

The  principal  salts  of  morphine  are  the  acetate,  the  hydro- 
chlorate  and  the  sulphate. 

Morphine  Acetas — Acetate  of  Morphine. 

Formula.     C17H19NO3,  HC2H3O2. 

Derivation.  Acetate  of  morphine  is  obtained  by  precipitat- 
ing morphine  from  the  hydrochlorate  of  morphine,  by  the 
aid  of  ammonia,  the  precipitate  resulting  being  washed  in  dis- 
tilled water  and  dissolved  and  neutralized  by  acetic  acid,  after 
which  it  is  evaporated  and  dried  by  heat.  It  is  in  the  form  of 
a  white  or  yellowish-white  amorphous  or  crystalline  powder, 
altogether  soluble  in  water  and  alcohol,  and  of  a  bitter  taste. 

Morphine  Hydrochloras  or  Murias — Hydrochlorate  or 
Muriate  of  Morphia. 

Formula,  C17H19NO2,  HCl  3H2O. 

Derivation.  Hydrochlorate  or  Muriate  of  Morphine  is  ob- 
tained by  macerating  opium  in  distilled  water,  evaporating  to 
a  small  quantity,  and  adding  chloride  of  lime,  and  concen- 
trating the  solution  until  it  becomes  solid  when  cool,  after 
which  it  is  pressed,  washed  with  distilled  water,  again  evapor- 
ated, cooled  and  pressed,  and  again  dissolved  in  distilled  water, 
when  it  is  subjected  to  animal  charcoal,  to  remove  the  coloring 
matter,  filtered,  and  precipitated  by  ammonia  the  codeia  of  the 
opium  remaining  in  solution.  The  crystals  resulting  are  then 
dissolved  in  muriatic  acid,  and  the  morphine  allowed  to  crys- 
tallize into  Hydrochlorate  or  Muriate  of  Morphine.  It  is  in 
the  form  of  snow-white,  feathery,  flexible  and  acicular  crystals, 
of  a  bitter  taste,  and  silky  lustre  and  altogether  soluble  in 
water  and  alcohol. 


236  DENTAL    MEDICINE. 


Morphine  Sulphas — Sulphate  of  Morphine. 

Formula,  C^.Yi^^'^O^,  2H2SO4,  5HO2O. 

Derivation.  Sulphate  of  morphine  is  obtained  by  dissolving 
morphine  in  boiling  alcohol,  and  saturating  it  while  hot  with 
sulphuric  acid,  the  coloring  matter  being  removed  by  animal 
charcoal;  it  is  then  boiled  and  filtered  while  at  the  boiling 
temperature.  Upon  cooling  the  sulphate  is  deposited  in  the 
form  of  white  feathery  acicular  crystals  of  a  silky  lustre,  odor- 
less, with  a  bitter  taste  and  a  neutral  reaction.  It  is  soluble  in 
water  and  alcohol. 

Medical  Properties  and  Action  of  the  Salts  of  Morphine. 
The  salts  of  morphine  possess  anodyne,  hypnotic  and  antispas- 
modic properties,  and  are  less  stimulating,  less  convulsant,  and 
more  hypnotic  and  anodyne  than  opium,  and  they  also  pro- 
duce less  constipation,  and  less  diaphoretic  action  than  opium. 
After  the  administration  or  insertion  of  the  ordinary  dose, 
which  is  one-sixth  to  one-fourth  of  a  grain,  there  is  experi- 
enced a  sense  of  heat  and  flushing  of  the  face ;  which  may  be 
preceded  by  some  pallor,  a  fullness  of  the  head,  giddiness, 
noise  in  the  ears,  and  frequently  nausea,  sometimes  epigastric 
pain.  The  vertigo  may  cause  a  staggering  walk  and  inability 
to  maintain  an  upright  position.  Injection  of  the  conjunctiva 
and  contraction  of  the  pupils  occur  at  the  same  time  that  the 
cerebral  effects  are  felt.  The  lips  have  a  bluish  appearance, 
the  mouth  and  tongue  dry,  deglutition  is  painful  and  the  voice 
becomes  husky.  During  these  symptoms  the  anodyne  effects 
are  manifested  by  the  relief  of  pain  and  spasm,  with  perfect 
calmness  of  mind  and  tranquillity.  While  the  effect  is  gene- 
rally hypnotic,  yet  in  some  cases  there  is  extreme  wakefulness, 
with  great  mental  activity,  and  when  sleep  occurs,  instead  of 
its  being  calm,  the  respirations  are  slow,  noisy  and  labored, 
the  patient  being  disturbed  by  dreams  and  visions.  While 
the  action  of  the  heart  is  diminished  in  frequency,  there  is  a 
considerable  rise  in  the  arterial  tension.  When  a  hypodermic 
injection  of  morphine  has  been  made  there  is  experienced  an 
itching  of  the  nose,  which  may  extend  to  the  entire  cutaneous 
surface.     The  skin,  which  is  at  first  dry,  becomes  moist,  from 


MORPHINA MORPHINE.  237 


diaphoresis,  which  is  sometimes   profuse.     The  secretions  of 
the  mucous  surface  are  also  arrested  as  a  primary  effect. 

If  morphine  is  administered  after  a  full  meal,  its  effect  is  to 
suspend  digestion  for  some  time,  and  also  to  temporarily  arrest 
the  intestinal  movements  and  diminish  the  urinal  discharge, 
and  make  its  emission  difficult,  on  account  of  the  temporary 
loss  of  contractile  power  of  the  bladder  and  of  the  ejaculatory 
muscles.  When  the  narcotic  effects  of  morphine  decline,  there 
is  generally  experienced  headache,  confusion  of  mind,  anorexia 
and  nausea.  When  a  poisonous  dose  is  administered,  a  pro- 
found state  of  narcotism  quickly  ensues,  the  pulse  becomes 
slow  and  feeble,  the  respiration  slow  and  indistinct,  the  skin 
cold  and  covered  with  perspiration,  the  face  pale,  blue  and 
ghastly,  the  conjunctiva  deeply  injected,  the  pupils  greatly 
contracted,  and  reflex  movements  entirely  destroyed.  Half  a 
grain  of  morphia  is  the  smallest  dose  which  has  proved  fatal 
to  an  adult,  but  other  cases  are  recorded  where  one  grain  de- 
stroyed life.  It  chiefly  affects  the  cerebro-spinal  functions,  and 
causes  death  by  paralyzing  the  respiratory  muscles. 

The  antidotes  in  cases  of  poisoning  are  the  stomach  pump, 
emetics,  cold  affusions,  counter-irritation,  strong  coffee,  active 
stimulants,  atropine  by  hypodermic  injection,  electro-magne- 
tism, and  artificial  respiration. 

Therapeutic  Uses.  The  salts  of  morphine  are  employed  in  all 
neuralgic  affections,  for  the  relief  of  pain  from  whatever  cause, 
and  to  induce  sleep;  also  in  diseases  of  the  heart,  chronic  gas- 
tritis, delirium  tremens,  tetanus,  colic,  spasms,  dysentery,  chol- 
era, cough  of  pulmonary  affections,  cerebro-spinal  meningitis, 
puerperal  fever,  convulsive  diseases,  vomiting,  colica  pictonum 
diarrhoea,  diabetes,  gangrene,  etc.,  etc.  For  hypodermic  injec- 
tion, the  acetate  of  morphine  is  supposed  to  possess  some 
advantages  over  the  other  salts,  such  as  the  sulphate  and 
muriate,  one  of  which  is  its  greater  solubility.  Morphine  is 
contraindicated  where  there  is  a  tendency  to  apoplexy  or 
coma. 

Dose.  Of  the  Salts  of  Morphine,  gr.  Ye  to  gr.  'Y,.  One- 
sixth  of  a  grain  of  either  of  the  salts  of  morphine   is   equiva- 


238  DENTAL   MEDICINE. 


lent  to  a  grain  of  opium,  or  twenty-five  drops  of  the  tincture 
of  opium  (laudanum). 

For  hypodermic  injections  the  dose  of  salts  of  morphine  is 
gr.  }i  to  j4- 

For  endermic  application,  gr.  )4  to  j  of  morphine  may  be 
sprinkled  on  a  surface  which  has  been  blistered  to  remove  the 
cuticle,  over  the  seat  of  pain ;  but  the  hypodermic  method  is 
the  most  effectual. 

Dental  Uses.  For  dental  use,  the  acetate  of  morphine  and 
the  muriate  of  morphine  are  preferable  to  the  sulphate,  on  ac- 
count of  their  greater  solubility  and  greater  chemical  affinity 
with  the  tissues  on  which  they  are  to  act.  The  acetate  of 
morphine  is  also  preferred  to  the  other  salts  as  an  ingredient 
of  nerve  paste  for  destroying  the  vitality  of  the  pulps  of  teeth, 
on  account  of  its  chemical  and  mechanical  compatibility  with 
the  pulp  tissue,  giving  relief  as  an  anodyne  when  the  sulphate 
would  irritate.  Concerning  the  action  of  morphine  when  com- 
bined with  arsenious  acid,  its  effect  is  anodyne,  modifying  the 
irritant  action  of  the  arsenic,  and  preventing,  to  a  considerable 
degree,  the  intense  pain  which  follows  its  application  to  vitalized 
structures.  Besides  its  use  in  devitalizing  mixtures  and  as  an 
obtunder  of  sensitive  dentine,  morphine  is  employed  for  the 
temporary  relief  of  odontalgia,  for  such  a  purpose  being  com- 
bined with  carbolic  acid,  sweet  spirits  of  nitre,  oil  of  cloves 
and  other  anodyne  agents. 

A  paste  made  of  morphine  and  creasote  (or  carbolic  acid), 
is  much  used  for  obtunding  the  sensitiveness  of  dentine. 

For  internal  administration  in  facial  and  other  neuralgias, 
morphine  is  combined  with  atropine  in  the  proportion  of  atro- 
pine, gr.  ^1^  to  ^io ;  morphine,  gr.  ^  to  ^;  hypodermically  injected. 
Morphine  in  combination  with  carbolic  acid  is  also  employed 
to  relieve  the  pain  of  an  exposed  and  painful  pulp. 

DENTAL  FORMULA. 

For  Odontalgia.  For  Itching  of  Inflamed  Surfaces. 

K.     Morphinse  Acetatis gr.  xx  R.     Morphinse  Sulphat...gr.  vj 

Creasoti,     (vel     Acidi  Sodii  Boratis ^ss 

Carbolici) ^ij.         M.  Aquae  Rosse f^viij.        M. 

SiGNA. — Apply  to  carious  cavity  on  a  SiGNA. — To  be  used  as  a  lotion, 
pellet  of  cotton. 


MYRRHA MYRRH.  239 


To  Relieve  the  Paiti  following  the  Ex-  For  Odontalgia, 

traction  of  Teeth,  and  a  Local  Anas-  White. 

ihetic.  R.     Morphinse  Acetatis...gr.  XX 

R.     Morphinje g"".  vj  Olei  Caryophilli, 

Tincturoe  Aconiti,  Spiritus   ^theris   Ni- 

Chloroformi,  trosi aa .^ij.  M. 

Alcoholis aa f.^  j-         M.  Signa. — Apply  on  a  pellet  of  cotton. 

SiGNA. — Apply  on   cotton,  or  with  an  For  Devitalizing  Pulps  of  Teeth. 

applicator,  as  a  local  anaesthetic.  R.     MorphinEe  Acetatis...gr.  j 

(See  Formulae  under  Arsenious  Acid.)  Acidi  Arseniosi gr.  ij 


Creasoti q.  s.  M. 

Fiat  massa. 
Signa. — Apply  a  sufficient  quantity  to 
exposed  surface  of  pulp  on  cotton. 


MYRRPTA— MYRRH. 

Source.  Myrrh  is  a  gum-resinous  exudation  from  a  small, 
shrubby  tree — Balsamodendron  Myrrha,  of  the  natural  order 
AmyridacecB,  growing  in  Arabia  and  the  northeastern  coast  of 
Africa.  It  is  obtained  in  the  form  of  small,  irregular  frag- 
ments or  tears,  or  in  larger  masses,  composed  of  agglutinated 
portions.  The  juice  exudes  spontaneously  from  the  stem  of 
the  tree,  and  concretes  upon  the  bark.  When  pure,  myrrh  is 
of  a  reddish-yellow  or  reddish-brown  color,  translucent,  with 
a  strong,  peculiar  fragrant  odor  and  a  bitter  aromatic  taste, 
brittle  and  pulverizable.  Its  powder  is  of  a  light  yellow  color; 
when  of  a  dark  color,  it  is  impure.  When  powdered  myrrh 
is  rubbed  up  for  fifteen  minutes  with  an  equal  weight  of  muriate 
of  ammonia  and  fifteen  times  its  weight  of  water  gradually 
added,  and  it  dissolves  quickly  and  entirely,  it  may  be  consid- 
ered pure. 

Medical  Properties  and  Action.  Myrrh  is  stimulant,  astrin- 
gent, expectorant  and  emmenagogue.  It  stimulates  the  digest- 
ive organs  and  improves  the  appetite.  In  large  doses  of  a 
half  ounce,  it  causes  a  burning  sensation  in  the  stomach, 
increased  arterial  excitement,  and  profuse  diaphoresis,  with  a 
great  influence  on  the  urinary  passages.  It  diminishes  dis- 
charges from  mucous  membranes  when  internally  administered, 
and  is  a  useful  external  application  for  relaxed  tissues. 


240  DENTAL    MEDICINE. 


Therapeutic  Uses.  Myrrh  is  internally  administered  in 
chronic  catarrh,  humoral  asthma,  amenorrhcea,  chlorosis,  leucor- 
rhoea,  chronic  bronchitis,  etc.,  etc.;  and  in  conbination  with 
chalybeates  and  aloes  in  uterine  affections. 

Locally,  myrrh  is  applied  to  inflamed,  ulcerated  and  aphthous 
surfaces. 

Dose.  Of  powdered  Myrrh,  gr.  x  to  5ss,  in  pill  or  suspended 
in  water. 

Tincture  of  Myrrh — Tinctura  MyrrhcB  (myrrh,  Siij ;  alco- 
hol, Oij.)  Dose.  f5ss  to  f5j.  Is  used  internally  and  exter- 
nally. 

Dental  Uses.  Myrrh,  in  the  form  of  the  powder  and  tincture, 
is  employed  as  a  local  application  to  inflamed,  ulcerated  and 
spongy  gums,  ulcerations  of  mucous  membrane  of  the  mouth 
and  throat,  in  the  form  of  a  gargle  ;  also  in  mercurial  stoma- 
titis, indolent  ulcers,  aphthous  sore  mouth  of  children.  The 
diluted  tincture  forms  a  stimulating  gargle  or  mouth  wash,  and 
the  powder  is  employed  as  an  ingredient  of  dentifrices,  for  its 
stimulating  and  astringent  properties. 

NITROUS  OXIDE— PROTOXIDE  OF  NITROGEN. 
Laughing  Gas. 

Formula.     NjO.     Sp.  gr.  1.525. 

Derivation.  The  discovery  of  nitrous  oxide  gas  was  made 
by  Dr.  Priestly  in  1776,  and  scientific  investigations  demon- 
strating its  respirability,by  Sir  Humphrey  Davy,  the  results  of 
which  were  published  some  twenty  years  afterwards.  To  Dr. 
Horace  Wells,  a  dentist  of  Hartford,  Connecticut,  is  due  the 
credit  of  having  demonstrated  its  property  as  an  anaesthetic 
agent  for  the  relief  of  pain  during  surgical  operations,  in  the 
year  1844.  Nitrous  oxide  is  obtained  by  heating  the  salt 
nitrate  of  ammonia  in  a  glass  retort  until  it  melts,  and  then 
boils,  dissolving  into  a  vapor  of  water  and  into  a  permanent 
gas. 

The  salt  nitrate  of  ammonia  is  obtained  in  three  forms — the 
crystallized,  the  granulated  and  the  fused.  The  fused  form  is 
prepared  by  melting  the  crystallized  nitrate  of  ammonia,  and 


NITROUS    OXIDE PROTOXIDE   OF    NITROGEN.  241 

allowing  it  to  solidify  on  cooling  ;  the  granulated  is  prepared 
by  evaporating  the  solution  to  a  density  sufficient  to  solidify  on 
cooling,  and  agitating  the  mass  until  it  becomes  cool. 

As  it  is  very  important  to  use  a  pure  form  of  the  nitrate  of 
ammonia  in  the  generation  of  nitrous  oxide  gas  the  salt, 
either  in  the  fused  or  granulated  state,  may  be  tested  by  heat- 
ing it  on  platinum,  when  the  nitrate,  if  pure,  should  volatilize 
perfectly.  It  may  also  be  tested  by  a  few  drops  of  chloride  of 
barium,  which  should  not  give  a  precipitate  when  added  to  the 
nitrate  of  ammonia ;  should  it  do  so,  then  sulphuric  acid  is 
present ;  or,  the  nitrate  of  ammonia  may  be  tested  by  a  solu- 
tion of  nitrate  of  silver,  which  will  also  give  a  precipitate,  if 
chlorine  is  present.  The  test  with  nitrate  of  silver  may  be 
made  by  dissolving  a  drachm  of  the  nitrate  of  ammonia  in 
half  a  glass  of  distilled  water  and  adding  a  few  crystals  of  the 
nitrate  of  silver.  If  the  nitrate  of  ammonia  is  pure,  the  solu- 
tion will  remain  perfectly  clear,  but  should  chlorine  be  present, 
it  will  show  a  clouded  appearance,  and  should  be  discarded,  as 
it  is  not  fit  to  generate  the  gas  from. 

The  salt  nitrate  of  ammonia  is  a  white,  crystalline  substance, 
formed  by  neutralizing  dilute  nitric  acid  by  means  of  carbon- 
ate of  ammonia,  and  is  so  constituted  as  to  be  resolved  into 
nitrous  oxide  and  water.  A  pound  of  the  salt  will  generate 
about  thirty  gallons  of  the  gas.  In  generating  nitrous  oxide 
gas,  care  must  be  taken  to  preserve  its  purity ;  consequently  it 
becomes  important  to  maintain,  as  nearly  as  possible,  an  equal 
temperature  during  its  manufacture,  and  should  any  nitric  oxide 
— ^binoxide  of  nitrogen — be  formed,  which  may  be  done  by 
too  high  a  heat  under  the  retort,  it  is  necessary  to  remove  it 
and  other  impurities,  by  the  aid  of  solutions  of  caustic  potash 
and  copperas ;  the  caustic  potash  neutralizing  any  free  nitric 
acid  present,  and  the  copperas  removing  either  chlorine  or 
nitric  oxide.  The  salt  nitrate  of  ammonia  is  perfectly  fused  at 
226°  F.  emij;s  white  fumes  at  302°  F.  and  begins  to  evolve 
gas  at  460°  F,  At  500°  F.  the  impurity,  nitric  oxide  is  given 
off;  hence  the  temperature  during  the  process  should  not  be 
permitted  to  rise  above  482°  F.  which  can  be  determined  by 


242  DENTAL    MEDICINE. 


thermometers  prepared  for  the  purpose.    No  red  fumes  should 
pass  from  the  retort. 

Nitrous  oxide  gas,  as  principally  used  at  the  present  time, 
is  in  the  form  of  condensed  gas,  being  liquefied  and  solidified 
under  great  pressure  and  secured  in  iron  cylinders,  from 
which  it  escapes  into  an  inhaling  bag  when  needed  for  use,  by 
turning  a  stop-cock.  The  advantages  of  the  condensed  form 
of  the  gas  are  its  purity,  convenience  for  use  whenever  needed, 
the  large  supply  which  can  be  kept  for  use,  and  the  freedom 
from  deterioration  notwithstanding  its  age. 

Nitrous  oxide  is  an  elastic,  colorless  gas,  with  a  faint  but 
agreeable  odor,  and  a  sweetish  taste,  which  it  imparts  to  water. 
Under  a  pressure  of  50  atmospheres  at  about  45°  F.  it  be- 
comes a  clear,  colorless  liquid,  and  at  about  150°  F.  below 
zero,  it  freezes  into  a  beautiful,  clear,  crystalline  solid.  By  the 
evaporation  of  this  solid,  a  degree  of  cold  may  be  produced 
far  below  that  of  carbonic  acid  bath  in  vacuo,  or  lower  than 
170°  F.  The  washing  of  nitrous  oxide  gas,  and  the  retention 
of  it  over  water  for  any  length  of  time,  is  attended  with  con- 
siderable loss,  as  much  of  it  is  absorbed,  especially  if  the  water 
is  cold ;  such  loss  may  be  avoided  to  a  great  extent  by  using 
water  of  an  elevated  temperature  or  a  strong  solution  of  com- 
mon salt.  The  impurities  of  nitrous  oxide  gas  are  air,  water, 
nitric  oxide  or  binoxide  of  nitrogen,  chlorine  and  hyponitric 
acid.  The  mixture  with  air,  which  may  occur  in  the  receiver 
or  when  the  patient  is  inhaling  the  gas,  merely  dilutes  it,  as 
does  also  the  vapor  of  water.  Nitric  oxide,  however,  is  a 
dangerous  impurity,  and  with  others  may  be  generated  even 
when  pure  nitrate  of  ammonia  is  used  in  preparing  the  gas ; 
this  impurity  is  also  one  of  the  most  difficult  to  separate  from 
the  gas.  Like  nitrous  oxide,  nitric  oxide  is  a  colorless  gas, 
lighter  and  less  soluble  in  water,  and  if  it  is  generated,  is 
liable  to  pass  through  the  washing  solutions  into  the  gasometer 
or  receiver;  nitric  oxide,  however,  need  not  be  generated  if 
the  proper  care  is  observed  with  regard  to  the  degree  of  heat 
under  the  retort  which  contains  the  nitrate  of  ammonia. 

Chlorine  is  also  a  dangerous  impurity,  and  may  be  set  free 


NITROUS    OXIDE PROTOXIDE    OF    NITROGEN,  243 

if  the  salt  nitrate  of  ammonia  contains  muriate  of  ammonia 
(sal-ammoniac),  and  chloride  of  ammonium.  To  prevent  such 
contamination  the  tests  of  the  salt  before  referred  to  may  be 
made.  Nitrous  oxide  gas  supports  combustion  with  almost 
the  same  promptness  as  pure  oxygen ;  and  although  nearly 
identical  in  constitution  with  atmospheric  air,  it  differs  from 
it  both  in  the  proportion  of  its  constitutional  elements  and 
in  the  manner  of  their  association.  Nitrous  oxide  contains 
about  one-third  of  oxygen  to  two-thirds  of  nitrogen,  while 
atmospheric  air  has  only  about  one-fifth  of  oxygen  to  four- 
fifths  of  nitrogen. 

Again,  in  nitrous  oxide,  the  elements  nitrogen  and  oxygen 
are  in  chemical  combination  with  each  other,  while  in  atmo- 
spheric air  there  is  no  apparent  chemical  union  whatever. 

Medical  Properties  and  Actio7t.  Nitrous  oxide  gas  is  not 
only  the  most  pleasant,  but  is  the  safest  general  anaesthetic  in 
use,  and  the  greatest  objection  to  its  administration  is  the  very 
short  anaesthetic  stage  which  it  induces,  unless  the  inhalation 
of  the  gas  be  continued,  which  is  impossible  in  operations 
upon  the  mouth.  When  inhaled,  the  first  effect  is  dizziness, 
with  ringing  noises  in  the  ears,  a  tingling  sensation,  extending 
to  the  extremities,  an  uplifting  of  the  whole  system,  followed 
by  fullness  or  expansion  of  the  chest,  and  a  loss  of  sensation 
throughout  the  entire  body.  According  to  the  temperament, 
the  stage  of  excitement  is  transient  or  prolonged  ;  in  some  cases 
there  are  strange  illusions,  with  a  form  of  intoxication,  which 
may  be  manifested  by  declamation,  singing,  laughing  or 
crying,  or  melancholy,  with  a  disposition  at  times  to  assault  all 
near.  Such  effects,  if  the  administration  is  interrupted,  soon 
pass  off.  For  surgical  operations,  the  gas  is  given  with 
less  admixture  of  the  air,  and  the  inhalation  persisted  in  until 
the  stage  of  excitement  is  overcome  and  insensibility  pro- 
duced, when  the  face  becomes  extremely  pale,  the  respira- 
tions, at  first  shallow,  become  deep  and  stertorous,  the  jaw 
fixed,  the  eyes  protruding,  and  a  bluish  and  purplish  color 
about  the  lips  and  face,  the  patient  presenting  a  very  alarming 
and  death-like   appearance,  a   condition  of  which  Bartholow 


244  DENTAL    MEDICINE. 

says, "  So  far  as  the  exterior  phenomena  can  afford  any  indica- 
tion of  the  nature  of  the  action,  is  an  asphyxiated  state.  The 
blood  ceases  to  be  oxygenated,  carbonic  acid  accumulates,  and 
the  centres  of  conscious  impressions  are  rendered  inactive  in 
consequence  of  the  deficient  supply  of  oxygen  and  the  excess 
of  carbonic  acid.  The  rational  indications  of  the  nature  of  the 
narcosis  produced  by  nitrous  oxide  are  confirmed  by  physio- 
logical experiment.  It  has  been  found  that  the  exhalation  of 
carbonic  acid  is  decidedly  diminished  by  the  inhalation  of  nit- 
rous oxide,  and  that  animals  live  no  longer  in  an  atmosphere 
of  this  gas  than  in  an  atmosphere  of  hydrogen."  The  same 
author  speaks  of  the  fatal  cases  that  have  occurred,  as  being 
with  propriety  attributable  to  the  lethal  action  of  this  gas,  and 
refers  to  various  cases  under  his  own  observation  in  which 
nervousness,  vague  mental  symptoms  and  headache,  have  been 
experienced  after  the  inhalations  ;  at  the  same  time  he  pro- 
nounces nitrous  oxide  to  be  almost  free  from  danger.  There 
is  no  doubt  but  that  the  prompt  action  of  nitrous  oxide  gas, 
and  the  rapid  subsidence  of  the  narcosis,  have  much  to  do 
with  its  safety,  and  account  for  the  impunity  with  which  it  is 
used.  Nitrous  oxide  gas  has  the  advantages  of  safety  ;  also 
rapid  anaesthesia,  which  is  generally  induced  in  from  thirty 
seconds  to  a  minute  and  a  half,  insensibility  often  occurring 
before  complete  unconsciousness ;  also  the  pleasant  odor  and 
taste,  thereby  preventing  repugnance  and  nausea ;  and  the 
complete  recovery  from  its  influence  without  unpleasant  after 
effects.  It  generally  requires  six  gallons  or  less  to  produce 
anaesthesia  with  nitrous  oxide  gas ;  hence  the  rubber  bag  from 
which  it  is  inhaled  should  have  a  capacity  of  about  eight 
gallons. 

Mode  of  Administration.  The  most  improved  apparatus 
consists  of  an  iron  cylinder  containing  lOO  gallons  or  more 
of  the  condensed  or  liquefied  nitrous  oxide,  to  which  is  at- 
tached a  rubber  gas  bag  and  inhaling  tube  with  a  double  valve 
and  mouth-piece.  The  patient,  for  dental  operations,  is  seated 
in  a  suitable  chair  which  will  admit  of  the  back  being  lowered 
to  such  a  degree  as  will  bring  the  patient  to  an  almost  hori- 


NITROUS    OXIDE PROTOXIDE   OF    NITROGEN.  245 

zontal  posture,  and  the  head  well  supported.  A  piece  of  India- 
rubber  or  a  firm  cork  to  which  a  thin,  strong  cord  is  attached, 
to  prevent  its  slipping  down  the  throat,  is  placed  between  the 
teeth,  so  as  to  prevent  the  closure  of  the  jaws,  for,  unlike  chloro- 
form and  ether,  the  muscles  become  rigidly  contracted  under 
the  influence  of  this  gas;  such  a  prop  also  prevents  injury  to 
the  front  teeth  by  the  patient  biting  too  hard  upon  the  mouth- 
piece of  the  inhaling  tube.  The  patient  is  then  directed  to 
breathe  deeply  and  regularly,  the  nose  being  held  to  prevent 
the  admixture  of  atmospheric  air,  and  the  same  precautions 
observed  as  are  necessary  when  administering  ether  or  chloro- 
form. (See  Ether).  The  anaesthetic  state,  or  "  surgical  period," 
as  it  is  termed,  is  generally  manifested  by  snoring,  although 
this  symptom  does  not  invariably  occur ;  when  it  does,  how- 
ever, it  indicates  a  state  of  profound  anaesthesia,  to  which  it  is 
not  necessary  to  carry  the  patient  in  performing  many  minor 
surgical  operations. 

As  more  or  less  excitement  follows  the  inhalation  of  this 
gas,  when  it  is  largely  mixed  with  atmospheric  air,  such  a 
condition  is  either  prevented  or  abbreviated  by  holding  the 
nose  of  the  patient  during  the  inhalation.  The  patient  should 
not  partake  of  food  for  at  least  two  hours  before  the  adminis- 
tration of  the  gas,  but  at  the  same  time  should  not  be  in  a 
weakened  condition  from  the  want  of  it ;  and  the  dress,  if  tisrht 
should  be  previously  loosened,  and  as  soon  as  the  operation 
is  completed  the  head  should  be  gently  moved  to  one  side,  to 
allow  the  blood  to  escape  from  the  mouth.  Fresh  air  should 
then  be  admitted  into  the  room,  and  the  patient  supplied  with 
it  by  means  of  a  fan. 

Therapeutic  and  Dental  Uses.  According  to  the  investi- 
gations of  Dr.  Ziegler,  nitrous  oxide  is  an  efficient  restorative 
when  administered  either  in  its  gaseous  state  by  the  lungs,  or 
in  conjunction  with  liquids  by  the  alimentary  canal.  He 
recommends  the  use  of  this  gas  in  moderate  quantities,  so  as 
not  to  generate  too  much  carbonic  acid.  Regarding  nitrous 
oxide  and  oxygen  as  of  primary  importance  in  asphyxia,  and 
the  natural  antidotes  to  narcotizing  agents  and  asphyxiated 


246  '  DENTAL   MEDICINE, 


conditions,  he  advocates  their  use  whenever  practicable,  either 
alone  or  in  combination  with  heat,  and  claims  that  they  will 
often  save  life  in  apparently  hopeless  cases. 

The  rapid  action  of  nitrous  oxide  and  the  transient  nature 
of  its  effects  on  the  system,  render  it  a  very  useful  anaesthetic 
agent  for  all  minor  surgical  operations — such  as  extracting 
teeth,  lancing  abscesses,  devitalizing  nerves  of  teeth,  etc.,  etc. 
It  has  also  been  successfully  employed  in  the  performance  of 
some  capital  surgical  operations,  where  the  anaesthesia  has 
been  kept  up  from  fifteen  minutes  to  half  an  hour.  It  has 
recently  been  recommended  to  use  during  the  first  part  of  an 
inhalation,  the  pure  nitrous  oxide  gas,  and  for  the  purpose  of 
prolonging  the  anaesthesia  with  less  danger,  to  dispense  with 
the  pure  gas  and  administer  a  mixture  of  oxygen  and  nitrous 
oxide  in  proportions  very  similar  to  the  air  we  breathe. 

OLEUM    AMYGDALA    DULCIS— OIL    OF     SWEET 

ALMONDS. 

Derivation.  The  oil  of  sweet  almonds  is  obtained  by  first 
depriving  the  almonds  of  the  brown  powder  adhering  to  their 
surface,  and  rubbing  them  together  in  a  piece  of  coarse  linen, 
grinding  them  in  a  mill  or  mortar,  and  then  submitting  them 
to  pressure  in  canvas  sacks  between  slightly  heated  plates  of 
iron.  The  oil,  which  is  at  first  turbid,  is  clarified  by  rest  and 
filtration.  It  is  clear,  colorless,  or  of  a  slight  greenish-yellow 
tinge,  nearly  inodorous,  with  a  bland,  sweetish  taste.  It  will 
remain  liquid  at  temperatures  below  the  freezing  point  of  water. 

Medical  Properties  and  Action.  The  oil  of  sweet  almonds 
is  demulcent. 

Therapeutic  Uses.  It  is  employed  as  an  emulsion  in  pul- 
monary affections  with  cough,  and  as  a  vehicle  for  other  medi- 
cines. 

Dental  Uses.  The  oil  of  sweet  almonds  forms  a  pleasant 
and  soothing  application  for  excoriations  of  the  lips  and  in- 
flamed mucous  membranes  ;  also  for  a  soothing  application  to 
the  small,  simple,  but  painful  ulcers  which  sometimes  appear 
upon  the  gums,  mucous  membrane  of  the  cheeks,  and  the 


OLEUM  CARYOPHILLI OIL  OF  CLOVES.         247 

tongue.  Almond  mixture — Mistiwa  Amygdala; — is  made  by- 
dissolving  a  mixture  of  half  an  ounce  of  blanched  sweet 
almonds,  30  grains  of  gum  arable  and  120  grains  of  sugar,  in 
half  a  pint  of  distilled  water.     It  forms  a  pleasant   demulcent. 

OLEUM  CAJUPUTI— OIL  OF  CAJUPUT. 

Source.  The  volatile  oil  of  the  leaves  of  melaleuca  cajuputi, 
a  tree  indigenous  in  Batavia  and  Singapore.  It  is  transparent, 
of  a  green  color,  with  an  odor  like  camphor,  and  a  warm, 
pungent  taste. 

Medical  Properties  and  Action.  Cajuput  oil  is  a  diffusible 
stimulant,  antispasmodic  and  diaphoretic.  Internally  adminis- 
tered, it  causes  a  sensation  of  warmth  in  the  stomach,  and 
excites  the  action  of  the  heart  and  arteries,  afterwards  producing 
copious  diaphoresis.  Externally,  either  alone  or  in  combina- 
tion with  equal  parts  of  soap  liniment  or  olive  oil,  it  is  an 
efficient  rubefacient  and  stimulant  embrocation.  Its  use  is 
becoming  more  common. 

Therapeutic  Uses.  It  is  employed  internally  as  an  antispas- 
modic stimulant  in  typhus  and  other  low  fevers,  spasmodic 
cholera,  gout  and  rheumatism,  neuralgic  affections,  hysteria, 
flatulence  and  flatulent  colic,  headache,  nausea,  etc.  Externally, 
in  neuralgia,  headache,  gout,  rheumatism,  lumbago,  sprains, 
contusions,  paralysis,  etc.,  etc. 

Dose.  Of  Cajuput  Oil,  gtt.  j  to  gtt.  v.,  in  emulsion,  or  on 
sugar. 

Dental  Uses.  Cajuput  Oil  is  an  efficacious  remedy  for  the 
relief  of  odontalgia,  applied  on  lint  or  cotton  to  the  carious 
cavity  of  the  tooth ;  also  in  neuralgic  affections,  if  they  are  not 
connected  with  inflammatory  action. 

OLEUM    CARYOPHILLI— OIL   OF  CLOVES. 

Source.  Oil  of  cloves  is  obtained  from  the  dried  flower 
buds  of  the  caryophillus  aromaticus,  an  evergreen  tree,  of  the 
natural  order  Myrtacea — myrtle  order — a  native  of  the  Indies. 
The  unexpanded  buds  are  of  a  dark  brown  color,  with  a 
yellowish  red  tint. 


248  DENTAL    MEDICINE. 


The  oil  is  prepared  by  distilling  cloves  with  water,  to 
which  common  salt  is  added,  in  order  to  raise  the  tempera- 
ture to  the  boiling  point.  It  has  a  fragrant  odor  and  a  hot, 
acrid  taste. 

Medical  Properties  and  Action.  Oil  of  cloves  contains  tan- 
nic acid,  a  pungent  volatile  oil,  resin,  etc.,  and  two  substances 
— a  hydro-carbon  caryophillin,  and  an  oxygenated  oil,  eugenol, 
called  an  acid  on  account  of  its  possessing  acid  properties. 
Oil  of  cloves  is  an  aromatic  stimulant,  and  a  powerful  stimu- 
lant. Although  it  is  a  very  fluid,  clear  and  colorless  prepara- 
tion when  fresh,  it  becomes  yellow  by  exposure,  and  ultimately 
reddish  brown,  with  the  odor  of  cloves  and  a  hot,  aromatic 
taste.  Like  cloves,  the  oil  acts  less  upon  the  system  at  large 
than  on  the  part  to  which  it  is  immediately  applied. 

Therapeutic  Uses.  Oil  of  cloves  is  sometimes  administered 
to  relieve  nausea  and  vomiting,  to  correct  flatulence,  and  excite 
digestion  when  languid ;  but  its  chief  use  is  to  modify  the 
action  of  other  medicines. 

Dose.     Of  oil  of  cloves,  gtt.  ij  to  gtt.  vj. 

Dental  Uses.  In  dental  practice,  oil  of  cloves  is  employed 
to  relieve  odontalgia,  either  alone,  as  in  the  form  of  a  drop  or 
two  upon  cotton,  introduced  into  the  carious  cavity  of  a  tooth, 
and  obtunds  the  pain  by  an  over-stimulating  effect  upon  the 
irritable  pulp.  It  is  also  employed  for  the  same  purpose  in 
combination  with  other  agents,  such  as  morphia,  sweet  spirits 
of  nitre,  etc.  When  the  use  of  creasote  or  carbolic  acid  is 
prohibited,  owing  to  the  patient's  idiosyncracy,  the  oil  of  cloves 
may  be  substituted. 

The  oil  of  cloves  has  also  the  effect  of  rendering  creasote 
and  carbolic  acid  more  pleasant,  without  interfering  with  their 
action,  being  added  in  equal  admixture.  It  is  also  employed 
in  the  treatment  of  alveolar  abscess,  being  applied  like  crea- 
sote or  carbolic  acid. 


OPIUM — OPIUM.  249 


OPIUM— OPIUM. 

Source.  Opium  is  obtained  from  the  unripe  capsules  of  the 
papaver  somniferum,  of  the  natural  order  PapaveracecB — Poppy 
order,  in  the  form  of  a  concrete  juice,  which  exudes  from  inci- 
sions, and  which  is  permitted  to  evaporate  spontaneously. 
Commercial  opium  is  in  the  form  of  irregular  masses,  of  from 
a  few  ounces  to  several  pounds  in  weight,  with  a  moist,  brown 
or  chestnut  surface  and  a  peculiar  odor  and  nauseous  taste. 
The  purest  form  should  have  a  chestnut  color,  a  strong  aro- 
matic flavor,  and  a  dense  consistence,  and  break  with  a  deeply 
notched  fracture,  and  when  drawn  across  white  paper  leave  an 
interrupted  line.  The  alkaloid  morphine  is  the  most  important 
of  the  chemical  constituents  of  opium.     (See  Morphine.) 

Medical  Properties  and  Uses.  As  an  anodyne  and  hypnotic 
opium  possesses  the  power  of  relieving  pain  and  inducing 
sleep ;  it  relaxes  muscular  spasm,  and  hence  is  a  very  efficient 
remedy  in  tetanus,  spasms,  nervous  irritability,  and  discharges 
of  a  morbid  nature.  It  excites  the  circulation  as  a  first  action, 
and  increases  the  temperature  of  the  skin,  and  causes  an  agree- 
able exhilaration  of  the  intellectual  faculties,  so  much  so  as  to 
be  used  by  some  as  an  habitual  narcotic,  which  is  finally  de- 
structive to  both  the  physical  and  mental  functions.  But  the 
stage  of  excitement  is  very  transient,  and  is  succeeded  by  a 
falling  of  the  pulse,  a  diminished  susceptibility  to  external 
impressions,  confusion  of  mind  and  the  loss  of  consciousness 
in  deep  sleep.  Other  effects  are  also  manifested,  such  as  dry- 
ness of  the  throat,  thirst,  and,  in  some  cases,  nausea  and  vomit- 
ing, with  an  itching  miliary  eruption  on  the  skin. 

Taken  in  large  or  poisonous  doses,  opium  does  not  cause 
any  excitement,  but  giddiness  and  stupor  rapidly  supervene, 
with  a  lessening  in  the  frequency  of  the  pulse,  but  not  in 
fullness,  a  tendency  to  sleep  which  is  irresistible,  and  finally 
coma,  in  which  the  breathing  is  heavy  and  stertorous,  the 
pulse  slow,  and  the  pupils  contracted,  with  a  sinking  of  the 
pulse  and  relaxation  of  the  muscles  immediately  preceding 

17 


250  DENTAL    MEDICINE. 


death ;  in  the  case  of  children  death  is  often  preceded  by  vio- 
lent convulsions. 

The  antidotes  in  poisoning  by  opium  are  the  stomach  pump, 
emetics  in  double  doses,  such  as  sulphate  of  zinc,  in  doses  of 
gr.  XX  to  gr.  XXX,  or  sulphate  of  copper,  gr.  v  to  gr.  x ;  also 
mustard  in  powder,  Sss,  or  powdered  alum,  answer  as  emetics, 
strong  coffee,  keeping  the  patient  in  motion,  counter-irritation 
to  nape  of  neck,  flagellation  to  the  palms  of  the  hands  and 
soles  of  the  feet,  and  the  electro-magnetic  battery,  which  is 
often  efficient  when  other  measures  fail,  artificial  respiration, 
and  belladonna,  in  hypodermic  injections  of  its  alkaloid  atro- 
pine, in  solution.     No  local  lesions  are  found  after  death. 

Therapeutic  Uses.  Opium  as  an  anodyne  and  hypnotic  is 
employed  in  almost  all  diseases  where  the  necessity  of  as- 
suaging pain  and  inducing  sleep  is  required.  (See  Morphine.) 
Opium  is  contra-indicated  where  there  is  a  tendency  to  apo- 
plexy or  coma,  or  where  an  unusual  susceptibility  to  its  influ- 
ence exists,  and  it  should  be  administered  to  the  very  young 
and  very  old  with  great  caution.  When  long  administered  it 
is  necessary  to  increase  the  dose.  Externally,  in  the  form  of 
powder,  it  is  applied  to  irritable  ulcers,  etc.,  and  to  the  rectum, 
as  suppositories. 

Dose.  Of  Opium,  in  powder  or  pill,  as  an  anodyne  and 
hypnotic,  gr.  j. 

Dental  Uses.  Opium  is  employed  as  an  anodyne  in  con- 
vulsions of  teething,  but  must  be  administered  with  great  care 
and  in  small  doses ;  also  as  an  anodyne  preparatory  to  lancing 
the  gums  of  children ;  also  in  mercurial  salivation,  to  arrest 
the  excessive  secretion,  in  doses  of  gr.  j  every  four  hours  ; 
also  in  neuralgia ;  but  it  is  inferior  to  aconite.  A  small  lump 
of  opium  in  contact  with  an  aching  tooth  pulp  will  relieve  the 
pain,  or  the  powder  may  be  used  for  the  same  purpose.  In  the 
form  of  the  wine  and  tincture,  opium  is  serviceable  in  odontal- 
gia, dental  periostitis,  inflamed  gums  and  mucous  membrane 
of  the  mouth  ;  in  injections,  for  alveolar  abscess,  when  it  is 
often  used  in  combination  with  tincture  of  iodine.     The  wine 


PEPSINUM PEPSIN.  251 


of  opium  is  a  more  soothing  and  pleasant  application  than  the 
tincture  of  opium. 

ViNUM  Opii — JVine  of  Opium,  is  obtained  by  macerating 
two  ounces  of  powdered  opium,  together  with  cinnamon  and 
cloves,  in  one  pint  of  white  wine.     Dose,  ttiv  to  5j- 

Dental  Uses.  Employed  as  a  soothing  and  anodyne  appli- 
cation to  inflamed  and  tender  gums  and  mucous  membrane, 
odontalgia,  ulcerations  of  mouth,  alveolar  abscess,  dental  peri- 
ostitis, pulpitis,  etc. 

TiNCTURA  Opii — Tincture  of  Opium — laudanum,  is  com- 
posed of  powdered  opium,  Siiss  ;  diluted  alcohol,  Oj.  Dose, 
TT\^xiij,  or  25  drops,  equivalent  to  one  grain  of  opium.  Its 
strength  increases  Avith  age. 

One  drachm  of  the  tincture  contains  120  drops.  The  den- 
tal uses  are  the  same  as  for  wine  of  opium,  but  the  latter  is  the 
most  pleasant  application  for  the  mouth. 

TiNCTURA  Opii  Camphorata — Camphorated  Tincture  of 
Opium — paregoric  elixir,  is  prepared  by  macerating  sixty 
grains  of  opium  in  two  pints  of  diluted  alcohol,  with  sixty 
grains  of  benzoic  acid,  a  fluidrachm  of  oil  of  anise,  two  ounces 
of  clarified  honey,  and  forty  grains  of  camphor.  Dose,  foj 
to  f5j  or  a  tablespoonful,  containing  a  little  less  than  one 
grain  of  opium.  Dose  for  an  infant,  gtt.  v  to  xx.  This  is  an 
agreeable  preparation  for  children. 

TiNCTURA  Opii  Deodorata — Deodorized  Tincture  of  Opium, 
is  composed  of  the  watery  extract  of  opium,  washed  with  ether, 
which  is  afterwards  separated,  and  the  residue  dissolved  in 
water  and  mixed  with  enough  alcohol  to  preserve  it.  This 
preparation  of  opium  is  free  from  the  narcotina  and  many  other 
injurious  ingredients  of  opium,  and  is  a  valuable  preparation. 
Dose,  TTLv  to  f5j,  or  25  drops. 

PEPSINUM— PEPSIN. 

Source.  Pepsin  is  obtained  by  digesting  the  mucous  mem- 
brane of  the  stomach  of  the  pig,  calf  or  sheep,  which  has  been 
scraped  off,  chopped  finely,  and  macerated  for  several  days  in 
water,  in  a  solution  of  muriatic  acid,  from  which  the  pepsin  is 


252  DENTAL    MEDICINE. 


precipitated  with  chloride  of  sodium.  The  medicinal  prepara- 
tion is  in  the  form  of  a  nitrogenized,  light,  amorphous,  gray- 
ish-white or  fawn-colored  powder,  soluble  in  water  and  alco- 
hol, and  of  a  peculiar  odor  and  bitter,  nauseous  taste.  When 
quite  pure,  it  is  both  tasteless  and  inodorous.  When  decom- 
posed by  heat  it  no  longer  possesses  digestive  properties,  and 
much  of  what  is  sold  is  almost  or  wholly  inert.  Pure  pepsin 
is  an  artificial  digestive. 

Medical  Properties  and  Action.  Pepsin  is  an  essential  con- 
stituent of  the  gastric  juice,  and  digests  the  nitrogenous  con- 
stituents of  the  food,  converting  them  into  peptones.  Taken 
internally,  as  a  medicinal  preparation,  pepsin  increases  the 
appetite  and  allays  irritability  of  the  stomach.  It  should  be 
administered  immediately  before  meals,  and  no  hot  food  taken 
for  some  time  afterwards. 

Therapeutic  Uses.  Pepsin  is  employed  in  dyspepsia,  gastral- 
gia,  obstinate  vomiting,  infantile  diarrhoea,  apepsia  of  infants, 
vomiting  of  pregnancy,  cancer  and  chronic  ulcer  of  the  stom- 
ach, anaemia,  chlorosis,  atrophy,  etc.  Externally,  it  is  injected 
into  cancerous  tumors  and  morbid  growths  with  the  hypoder- 
mic syringe,  to  retard  their  progress. 

Dose.  Of  Pepsin  suspended  in  syrup,  Saccharated  pepsin — 
Pepsinuni  saccharatuin — gr.  v  to  gr.  x.  Syrup  of  orange  peel 
will  disguise  its  odor.  Vinum  Pepsini.  Dose,  5ss  to  5j  • 
Glycerinum  Pepsini.     Dose,  5ss  to  5j. 

Both  the  saccharated  pepsin  and  the  glycerole  are  un- 
changeable. 

Pepsin  appears  to  be  especially  efficient  in  cases  of  children; 
and  when  pepsin  and  a  small  quantity  of  hydrochloric  acid  are 
added  to  animal  broths  given  by  the  rectum,  in  cases  where 
food  is  rejected  by  the  stomach,  such  nourishment  is  very 
beneficial. 

Dental  Uses.  In  dental  practice,  pepsin  is  successfully  em- 
ployed in  the  treatment  of  putrid  pulps  of  teeth,  as  an  anti- 
septic and  deodorizer.  In  the  form  of  a  thin  paste  made  by 
mixing  pepsin  with  water  containing  some  two  per  cent,  of  hy- 
drochloric acid,  it  is  introduced  into  the  pulp  canal  after  the 


PLUMBI  ACETAS ACETATE  OF  LEAD.  253 


removal  of  the  decomposed  matter,  and  confined  by  a  tempo- 
rary filling  in  the  crown  cavity,  being  permitted  to  remain 
for  twenty-four  hours,  when  it  is  removed  and  the  canal 
syringed  with  tepid  water,  and,  if  necessary,  the  application  of 
the  pepsin  paste  repeated  until  the  odor  of  decomposition  can 
no  longer  be  detected.  Pepsin,  in  the  form  of  the  paste,  is 
also  applied  to  partially  decomposed  dentine,  which  may,  for 
good  reasons,  be  permitted  to  remain  immediately  over  the 
pulp  of  the  tooth,  as  the  action  of  the  pepsin  is  confined  to 
dead  matter  alone. 

DENTAL  FORMULA. 

For  Suppurating  Dental  Pulps.  For  Indigestion. 

(Oakley  Coles.)  (Mialhe  ) 

R.     Acidi  Hydrochlorici....TrLJ  R.     Pepsini ^iss 

Aquse  Destillatae rr^xl  Aquse f^viss 

Pepsini  Porci q.  s.  Vini  Xerici fjxiiss 

To  make  a  paste.  Alcoholis f^iij 

SiGNA. — To  be  applied  to  suppurating  Sacchari ^j. 

pulps.  Solve  et  cola. 

SiGNA. — A  tablespoonful    immediately 
after  each  meal. 

PLUMBI  ACETAS— ACETATE  OF    LEAD. 
Sugar  of  Lead. 

Formula.     Pb2C2H302,  3H2O. 

Derivation.  Acetate  of  lead  is  obtained  by  immersing  lead 
in  distilled  vinegar,  or  litharge  in  pyroligneous  or  crude  acetic 
acid  ;  when  the  acid  has  become  saturated,  the  solution  is  per- 
mitted to  cool  and  crystallize. 

Acetate  of  lead  is  a  white  salt,  in  the  form  of  beautiful,  bril- 
liant, needle-shaped  crystals,  like  long  prisms,  which  effloresce 
on  exposure  to  the  air.  It  has  a  sweet,  astringent  taste,  and 
an  odor  of  acetic  acid,  and  is  soluble  in  water  and  alcohol. 

Medical  Properties  and  Action.  Acetate  of  lead  is  sedative 
and  astringent,  checking  the  secretions  and  reducing  the  activ- 
ity of  the  capillary  system,  and  diminishing  the  force  and  fre- 
quency of  the  pulse.  Like  all  the  salts  of  lead,  it  is  an  irrit- 
ant and  corrosive  poison,  causing  gastro-enteric  inflammation. 
It  requires,  however,  a    large  quantity  (not  less  than  half  an 


254  DENTAL   MEDICINE. 


ounce)  of  the  acetate  of  lead  to  destroy  life,  as  much  of  it  is 
rejected  by  vomiting.  The  symptoms  of  lead  poisoning,  when 
the  lead  is  slowly  introduced  into  the  system,  are  loss  of  appetite 
and  strength,  wasting  of  flesh/paleness  of  the  face,  constipation, 
pain  in  the  joints,  dry  colic,  which  is  relieved  by  pressure,  neu- 
ralgia of  the  abdominal  muscles,  contraction  of  the  intestines, 
belly  drawn  towards  the  spinal  column,  contraction  of  the 
liver,  jaundiced  skin,  yellow  conjunctiva,  urine  colored  with 
biliary  coloring  matter,  a  blue  line  along  the  margin  of  the 
gum,  about  the  incisor  teeth  ;  also  at  times  a  bluish  discolora- 
tion of  the  mucous  membrane  of  the  lips  and  mouth,  dimness 
of  vision,  paralysis  of  the  extensor  muscles  of  the  fingers  and 
arms,  death  resulting  from  the  gradual  failure  of  nutrition  and 
the  paralysis  of  the  muscles  of  respiration. 

When  the  poisonous  dose  is  large,  there  is  intense  gastric 
irritation,  numbness,  paralysis,  coma,  and  collapse.  Iodide  of 
potassium  in  large  doses,  also  Epsom  salts  and  sulphur  baths, 
are  the  antidotes  in  chronic  cases  of  lead  poisoning,  and  for  the 
lead  colic,  alum  in  doses  of  one  or  two  drachms  every  three  or 
four  hours,  dissolved  in  some  demulcent  liquid,  is  considered 
to  be  the  best  remedy.  For  the  treatment  of  lead  paralysis, 
strychnia  and  electricity  are  employed.  The  blue  or  slate- 
colored  line  on  the  gums  is  supposed  to  be  due  to  a  deposition 
of  the  sulphide  of  lead. 

Therapeutic  Uses.  Acetate  of  lead  is  internally  administered 
in  dysentery,  diarrhoea,  cholera,  cholera  morbus,  phthisis, 
chronic  bronchitis,  pneumonia,  diseases  of  the  heart,  hemor- 
rhage from  the  lungs,  stomach,  kidneys,  nose,  etc. ;  diseases  of 
the  eye,  erysipelas,  skin  diseases,  chronic  gastric  catarrh,  gas- 
tralgia,  pyrosis,  summer  diarrhoea  of  children,  humid  asthma, 
whooping  cough,  etc. ;  but  the  danger  of  producing  toxic  effects 
must  be  remembered  in  its  internal  use. 

Externally,  solutions  of  lead  are  employed  to  relieve  super- 
ficial inflammations,  arrest  morbid  discharges,  and  allay  the 
pain  of  acute  inflammations.  Lead  should  not  be  given  with 
natural  waters  containing  lime,  carbonic  acid,  mineral  acids  and 


POTASSA  CAUSTlCA — CAUSTIC  POTASSA.         255 

salts,  vegetable  acids,  or  vegetable  astringents,  iodide  of  po- 
tassium, and  preparations  of  opium. 

Dose.  Of  Plumbi  Acetas,  gr.  ss  or  j  to  gr.  v,  two  or  three 
times  a  day. 

Liquor  Plumbi  Subacetatis  Dilutus — Diluted  Solution  of 
Sitbacctate  of  Lead. — Lead  zvater  is  composed  of  subacetate  of 
lead  solution,  foij ;  distilled  water,  Oj ;  and  is  a  mild  astringent 
and  sedative  when  applied  externally ;  it  is  never  prescribed 
internally.  It  arrests  discharges  from  suppurating  and  ulcer- 
ated mucous  surfaces,  and  promotes  the  resolution  of  acute 
superficial  inflammations. 

Dental  Uses.  Lead  water  is  employed  in  dental  practice,  to 
relieve  inflamed  gums  and  mucous  membrane  of  the  mouth ; 
as  an  application  to  indolent  and  foul  ulcers ;  also  in  the  treat- 
ment of  teeth  after  the  devitalization  and  removal  of  the  pulps, 
to  prevent  periosteal  trouble. 

It  proves  serviceable  when  applied  to  chapped  hands  and 

lips.     A  good   ointment  for  such  a  purpose  is  composed   of 

a  combination  of  lead  water,  camphor,  white  wax  and  oil  of 

almonds. 

DENTAL  FORMULA. 

For  Acute  InJlam7natioii  of  the  Mucous  For  Chapped  Hands  and  Lips. 

Membrane   of  the   Month   and   the  R .     Liq.  Plumbi  Subacetatis 

Gums.  Dilutus "^  vj 

R.     Plumbi  Acetatis ^j  Camphorse.,. gr- xl 

Tinct.  Opii gss  Cerse  Albse ^viij 

Aquce ^x.     M.  Olei  Amygdalae  Dulcis...Oj.       M, 

SiGNA. — Apply  as  a  lotion,  on  lint.  Fiat  Cerat. 

SiGNA. — Apply  as  an  ointment. 

POTASSA  CAUSTlCA— CAUSTIC  POTASSA. 
Hydrate  of  Potash — Fused  Potash — Oxide  of  Potassium. 

Formida.     HKO. 

Derivation.  Caustic  potash  is  prepared  by  boiling  a  solution 
of  potash  until  ebullition  ceases,  and  the  potassa  melts  or  as- 
sumes a  solidified  consistence,  when  it  is  poured  into  suitable 
moulds  and  kept  in  well-stopped  bottles,  as  it  rapidly  deli- 
quesces when  exposed  to  the  air.     It  dissolves  in  water  and 


256  DENTAL   MEDICINE. 


alcohol,  and  attracts  moisture.  Its  officinal  form  is  that  of 
sticks  of  a  white  and  somewhat  transparent  color,  but  upon  ex- 
posure to  the  air,  or  if  it  is  impure,  it  becomes  a  dingy  gray, 
greenish  or  bluish  color,  and  has  the  odor  of  slaking  lime. 
When  it  is  digested  in  alcohol,  so  as  to  free  it  from  such 
impurities  as  are  insoluble  in  alcohol,  it  is  called  alcoholic 
potassa. 

Medical  Properties  and  Action.  Caustic  potash  is  the  most 
powerful  caustic  and  escharotic  in  use,  and,  when  taken  inter- 
nally, is  a  corrosive  poison.  It  is  only  employed  externally. 
When  applied  to  a  part,  it  rapidly  destroys  its  vitality  to  a  con- 
siderable depth,  differing  in  this  respect  from  nitrate  of  silver 
(lunar  caustic),  as  the  latter  is  more  limited  in  its  action,  and 
does  not  liquefy  when  it  comes  in  contact  with  the  tissues. 
From  the  penetrating  action  of  caustic  potash,  it  is  necessary 
to  use  it  with  great  care.  It  is  very  deliquescent,  which  is  a 
great  objection  to  its  use  in  some  cases,  but  when  mixed  with 
an  equal  quantity  of  lime,  the  deliquescent  action  is  in  a  measure 
prevented ;  it  is  then  known  as  potassa  cum  calce — potassa  with 
lime,  and  is  in  the  form  of  a  grayish-white  powder,  which  is 
sometimes  made  into  a  paste,  under  the  name  of  Vienna  Paste, 
which  is  milder  and  less  deliquescent. 

Therapeutic  Uses.  Caustic  potassa  is  chiefly  employed  to 
open  abscesses,  and  in  the  treatment  of  chancres,  hospital  gan- 
grene, eczema,  malignant  growths,  to  arrest  the  sloughing  of 
carbuncles ;  in  tetanus,  applied  to  the  spine ;  bites  of  rabid 
animals  and  venomous  reptiles  ;  phlegmons  and  incipient  car- 
buncles, to  arrest  their  progress  ;  to  form  issues,  etc.  To  pre- 
vent its  coming  in  contact  with  neighboring  parts  a  piece  of 
adhesive  plaster  is  used,  with  an  opening  corresponding  in  size 
to  the  surface  on  which  the  caustic  is  to  act.  When  mixed 
with  water,  in  the  proportion  of  caustic  potash,  5iss  to  water, 
f§ij,  it  forms  a  rubefacient  solution. 

Deiital  Uses.  In  dental  practice,  caustic  potassa  is  employed 
in  gangrene  of  the  mouth  (cancrum  oris),  malignant  growths, 
fungous  growths  of  gum,  ulcers,  etc. ;  for  opening  abscesses, 
when  it  is  not  prudent  to  use  the  lancet. 


POTASSII    BROMIDUM BROMIDE    OF    POTASSIUM.  257 

POTASSII     BICARBONAS— BICARBONATE     OF 
POTASSIUM. 

Formula,  KHCO3. 

Derivation.  Bicarbonate  of  potassium  is  obtained  by  pass- 
ing carbonic  acid  through  an  aqueous  solution  of  carbonate 
of  potassium,  until  it  is  completely  saturated.  The  solution 
is  then  filtered  and  evaporated,  the  product  being  bicarbonate 
of  potassium,  in  the  form  of  transparent,  colorless  crystals,  of 
the  shape  of  irregular  eight-sided  prisms.  It  is  inodorous, 
with  a  saline  and  somewhat  alkaline  taste,  and  is  soluble  in 
water,  but  insoluble  in  alcohol.  Its  incompatibles  are  acids 
and  acidulous  salts,  etc. 

Medical  Properties  and  Action.  Bicarbonate  of  potassium 
is  antacid,  diuretic  and  antilithic.  In  large  quantities  it  is  a 
corrosive  poison. 

Tlierapeiitic  Uses.  It  is  employed  internally  in  acute  rheuma- 
tism, gout,  and  uric  acid  lithiasis,  diseases  of  the  skin,  calcu- 
lous affections,  etc.,  etc. 

Dose.     Of  Bicarbonate  of  Potassium,  gr.  v.  to  3j. 

Dental  Uses.  Bicarbonate  of  potassium  is  employed  in 
dental  practice,  as  an  antacid,  a  solution  being  serviceable 
as  a  mouth-wash,  to  prevent  injury  to  the  teeth  from  acid 
medicines, 

POTASSII  BROMIDUM— BROMIDE  OF  POTASSIUM. 

Fornmla.     KBr. 

Derivation.  Bromide  of  potassium  is  obtained  by  adding  a 
solution  of  pure  carbonate  of  potassium  to  a  solution  of  bro- 
mide of  iron.  The  iron  being  precipitated,  the  bromide  of 
potassium  is  obtained  from  the  solution  by  evaporation.  It  is 
in  the  form  of  white  crystals,  without  odor,  wholly  soluble  in 
water,  and  but  sparingly  soluble  in  alcohol,  and  having  a  pun- 
gent, saline  taste. 

Medical  Properties  aiid  Action.  Bromide  of  potassium  is 
stimulant,  sedative,  narcotic  and  antispasmodic,  and,  being  ab- 
sorbed into  the  system,  can  be  detected   in  the  blood,  urine. 


258  DENTAL    MEDICINE. 


faeces  and  mucus.  If  administered  in  considerable  quantity, 
the  action  of  the  heart,  respiration,  and  the  temperature  are 
depressed,  and  although  in  some  cases  a  transient  excitement 
may  be  caused  by  large  doses,  the  effect  of  this  agent  is  to 
induce  a  sound  and  refreshing  sleep,  and  if  its  use  is  long  con- 
tinued, a  constant  drowsiness  is  experienced.  Bromide  of  po- 
tassium also  has  the  power  of  lessening  the  sensibility  to  pain, 
especially  causing  a  loss  of  sensibility  of  touch  in  the  case  of 
the  mucous  membrane  and  skin,  which  is  due  to  the  local  action 
of  the  salt,  as  it  is  eliminated.  The  long  continued  use  of  this 
agent  also  causes  a  loss  of  motion,  and  if  it  is  injected  into 
the  tissues  of  a  limb,  it  will  cause  paralysis  of  motion  and 
sensibility.  It  also  diminishes  the  sexual  feeling,  and  the  con- 
dition which  a  long  course  of  the  bromides  develop  is  known 
as  bromisni,  which  is  characterized  by  weakness  of  mind,  con- 
fusion, headache,  pallor  and  anaemia,  uncertain  gait,  etc. 

Therapeutic  Uses.  Bromide  of  potassium  is  employed  as  an 
internal  remedy  in  cerebral  affections,  acute  rheumatism,  chol- 
era infantum,  sea  sickness,  vomiting  of  pregnancy  ;  affections 
of  the  heart,  as  shown  by  increased  action  ;  neuralgia,  maniacal 
excitement,  tetanus,  strychnia  poisoning,  epilepsy,  spasmodic 
asthma,  spasmodic  cough,  etc.,  etc.  \ 

Dose.     Of  Bromide  of  Potassium,  gr.  v  to  5j- 

Dental  Uses.  Bromide  of  potassium  is  a  useful  remedy  in 
infantile  convulsions  from  the  irritation  of  dentition,  and  is  also 
efficacious  in  preventing  such  conditions  by  relieving  the  irrita- 
tion ;  also  in  neuralgia,  due  to  diseased  teeth. 

As  its  local  effect  is  to  diminish  sensibility,  it  has  been  ap- 
plied to  the  pharynx  and  velum  palati,  in  order  to  prepare  such 
parts  for  the  taking  of  impressions  for  artificial  palates. 

POTASSII  CHLORAS— CHLORATE  OF  POTASSIUM. 

Fojnmda,  KCLO3 

Derivation.  Chlorate  of  potassium  is  obtained  by  passing 
an  excess  of  chlorine  through  a  solution  of  carbonate  of 
potassa  and  slaked  lime ;  the  chlorine  being  converted  into 
chloric  acid  by  the  hydrogen  of  the  lime  and  the  acid  com- 


POTASSII    CHLORAS CHLORATE    OF    POTASSIUM.  259 

billing  with  the  potassa,  forming  chlorate  of  potassium.  It  is 
in  the  form  of  colorless  or  white  crystals,  of  a  pearly  lustre, 
altogether  soluble  in  distilled  water,  and  in  twelve  parts  of 
cold  and  two  parts  of  boiling  water.  It  is  inodorous,  with  a 
cool,  saline  taste,  and  when  applied  to  animal  fluids  does  not 
decompose  them  nor  undergo  any  change,  although  perfectly 
soluble  in  such  fluids.  It  is  absorbed  by  the  blood,  and  is 
eliminated  by  the  kidneys. 

Medical  Properties  and  Action.  Chlorate  of  potassium  is 
detergent,  refrigerant,  diuretic,  and  stimulant,  and  its  action 
as  a  refrigerant  and  diuretic  is  similar  to  that  of  nitrate  of 
potassa.  It  improves  the  appetite,  and  on  account  of  the 
large  quantity  of  oxygen  it  contains  has  been  employed  in 
contaminated  conditions  of  the  blood  as  an  oxidizing  agent. 
Although  it  may  be  administered  with  impunity  in  very  large 
doses,  yet  excessive  quantities  have  given  rise  to  gastro-enteric 
inflammation,  with  fatal  effects. 

TJierapeiitic  Uses.  Chlorate  of  potassium  is  employed  in 
continued  and  typhoid  fevers,  neuralgia,  croup,  diphtheria,  sore 
throat,  chronic  bronchitis,  phthisis,  scrofula,  erysipelas,  scurvy, 
mercurial  salivation,  etc.,  etc.  Externally,  it  is  employed  in 
the  treatment  of  ozsena,  sore  throat  of  scarlatina,  pharyngitis, 
cancerous  sores,  ulcerated  surfaces,  fetid  and  scrofulous  ulcers, 
etc.,  etc. 

Dose.  Of  Chlorate  of  Potassium  gr.  v  to  9j,  every  three  or 
four  hours  ;  for  children — gr.  iij  in  sweetened  water  every  four 
hours  for  a  child  three  years  of  age ;  gr.  v  for  one  of  eight  or 
nine  years,  with  due  attention  to  the  bowels  and  constitution, 
regulating  the  former  and  supporting  the  latter.  In  the  case 
of  teething  children,  gr.  ij  may  be  administered  to  a  child  of 
one  year  of  age. 

Troches  of  Chlorate  of  Potassium  are  prepared  by  a  com- 
bination of  chlorate  of  potassium,  %v ;  sugar,  oxviij ;  traga- 
canth,  §ij ;  vanilla,  gr.  xxx ;  mixed  together  with  water  into 
a  mass  and  divided  into  480  troches,  each  of  which  contains 
gr.  V  of  chlorate  of  potassium ;  useful  for  sore  throat,  etc. 

Dental  Uses.     Chlorate  of  potassium  is  a  valuable  agent  in 


260  DENTAL    MEDICINE. 


dental  practice  as  an  internal  and  external  resolvent  and  deter- 
gent remedy  in  the  various  forms  of  stomatitis — inflammation 
of  the  gums,  aphthae  and  other  ulcerative  affections,  gangrenous 
stomatitis,  mercurial  stomatitis,  erysipelatous  inflammation  of 
the  mouth,  scurvy,  ulcers  of  the  gums,  cheeks  and  tongue, 
abraded  surfaces  of  mucous  membrane,  secondary  syphilitic 
ulcerations  of  the  mouth,  indolent  and  scrofulous  ulcers,  etc., 
for  such  purposes  being  used  alone  in  the  form  of  mouth- 
washes or  gargles,  or  in  combination  with  tannic  acid,  alum, 
borax,  glycerine,  etc.  In  the  treatment  of  mercurial  stomatitis, 
great  benefit  is  derived  from  both  its  internal  and  external  use. 
For  the  inflamed  gums  of  teething  children,  it  is  employed  as 
a  lotion,  with  beneficial  effects.  In  the  form  of  powder,  it  is  a 
useful  application  to  ulcera,ted  and  abraded  surfaces.  A  simple 
gargle  or  mouth  wash  may  be  made  by  dissolving  one  drachm 
of  chlorate  of  potassium  in  four  ounces  of  water,  or  half  an 
ounce  may^be  dissolved  in  a  pint  of  water. 

DENTAL  FORMULA. 

For  Inflamed  Gums,  Mucous  Membrane,  For  Ulceration  of  the  Mouth, 

etc.  (Bartholow.) 

R.     Potassii  Chlorat J^j  R.     Potassii  Chloratis ^j 

Sodii  Biboratis '7^\  Acidi  Carbolici j^ss 

Aquje  Destillatae ^  ij.       M.  Aquae  Destillatas ^  i"^-      M. 

SiGNA. — To  be  used  as  a  mouth  wash  or  SiGNA. — To  be  used  as  a  lotion, 

gargle.  p^^  Inflamed  Gums  and  Mouth. 

For  Ulceration   and  Inflammation  of  ^'  _   _    3  J 

the  Gums  and  Mucous  Membrane.  '  3  J 

.      (Stocken.)  Aqu^Destillat^ ^x.       M. 

R.     Potassii  Chloratis jij  SiGNA.-To  be  used  as  a  gargle. 

Sodii  Biboratis ^j  For  Ulcers  and  Suppurating  Wounds. 

Potassii  Nitratis ^^^ss  R.     Potassii  Chloratis pt.  j 

Aquae Destillatse ^viij.  M.  Glycerini pts.  x.     M. 

SroNA. — To  be  used  as  a  gargle.  Signa. — To  be  applied  as  a  lotion. 

For  Aphthotis  and  Secondary  Syphilitic  For  Inflamed  Mucous  Membrane. 

Ulcerations  of  the  Mouth  and  Fauces.     R.     Potassii  Chlorat sjj 

R.     Potassii  Chlorat ^iv  Aluminse  Sulph ^j 

Aquae  Destillatse ^x.       M.  Aquae  Destillatse ^  iv.       M. 

Signa. — To  be  used  as  an   antiseptic  Signa. — To   be    applied   as   a  mouth 

mouth  wash.  wash. 


POTASSII    NITRAS — NITRATE    OF    POTASSIUM.  261 

For  InJlainmatio7i  of  Gums  and  For  Inflamed  Gums  After  the  Extrac- 

Mucous  Membrane.  tion  of  Teeth. 

(Stocken.)  R.     Potassii  Chloratis ^ij 

li.     Potassii  Chloratis ;^ij  Tincturae  Kramerise, 

Sodii  Biboratis 5J  Glycerini ua f.fss 

Potassii  Nitratis ^ss  Aquae  Rosa; ^viij.  M. 

Tinct.  Arnicse ^ij  SiGNA. — To  be  used  as  a  gargle  6  or  8 

Aquse  Rosse ^  vij.     M.  times  daily,  to  harden  the  gums. 

SiGNA. — To  be  used  as  a  gargle. 


POTASSII   NITRAS— NITRATE  OF  POTASSIUM. 

Saltpetre — Nitre. 

Formula.     KNO2. 

Derivation.  Nitrate  of  potassium  is  obtained  in  the  native 
state  in  various  portions  of  the  world,  but  the  variety  employed 
for  medicinal  purposes  is  prepared  by  purifying  the  native 
production  of  India.  It  can  also  be  artificially  made  by  combining 
decayed  organic  animal  and  vegetable  matters,  or  by  the 
double  decomposition  of  nitrate  of  sodiui?:i  and  chloride  of 
potassium.  The  crude  nitre  is  refined  by  re-solution  and  crys- 
tallization. It  is  in  the  form  of  white,  crystalline,  six-sided 
prisms,  odorless,  with  a  sharp,  saline,  cooling  and  slightly  bitter 
taste,  wholly  soluble  in  water,  but  insoluble  in  alcohol. 

Medical  Properties  and  Action.  Nitrate  of  potassium  is  re- 
frigerant, sedative,  antiseptic,  diuretic  and  diaphoretic.  It  pro- 
motes the  secretions,  lessens  the  heat  of  the  body  and  the  fre- 
quency of  the  pulse.  For  allaying  febrile  excitement,  it  is 
frequently  employed  in  the  form  of  nitrons  powders  (nitre,  gr. 
X ;  tartar  emetic,  gr.  Yz  ;  calomel,  gr.  ^  to  ^). 

In  overdoses,  nitrate  of  potassium  causes  pain  and  heat  in 
the  stomach,  vomiting  and  purging  of  blood,  inflammation  of 
the  bowels,  great  prostration,  convulsions,  and  sometimes 
death. 

The  antidotes  are  emetics,  mucilaginous  and  demulcent 
drinks,  and  stimulants  to  sustain  the  sinking  powers  of  the 
system. 

Therapeutic  Uses.  Nitrate  of  potassium  is  employed  inter- 
nally as  a  refrigerant  in  febrile  affections  ;  in  inflammatory  dis- 


262  DENTAL    MEDICINE. 


eases,  acute  rheumatism,  scurvy,  purpura,  hsemoptysis,  passive 
hemorrhages,  asthma,  etc.  In  fevers  it  is  frequently  combined 
with  other  remedies.     The  vapor  is  used  in  spasmodic  asthma. 

Dose.     Of  Nitrate  of  Potassium,  gr.  ij  to  gr.  x. 

Dental  Uses.  In  dental  practice,  nitrate  of  potassium  has 
been  recommended  in  the  incipient  stages  of  alveolar  abscess, 
being  introduced  into  the  pulp  canal  and  secured  by  a  tempo- 
rary filling  in  the  crown  cavity  of  the  tooth.  It  is  also  em- 
ployed in  inflammatory  conditions  of  the  mucous  membrane 
of  the  mouth  and  throat,  in  the  form  of  gargles. 

i 

DENTAL  FORMULA. 

For  Iitflammation  of  the   Month    and    For  Inflamed  I\fucous    Membrane  and 
Throat.  Gums. 

(J.W.White.)  R.     Potassii  Nitratis ^ss 

R.     Potassii  Nitratis '7^\)\.o  v^'vj  Potassii  Chloratis ^ij 

Aquas  Destillatse Oj.         M.  Sodii  Biboratis ^j 

SiGNA. — To  be  used  as  a  gargle.  Aquse  Destillatse ^'^i^j-    ^• 

SiGNA. — To  be    used  as   an    antiseptic 
and  refrigerant  mouth  wash. 

POTASSII    PERMANGANAS— PERMANGANATE   OF 
POTASSIUM. 

Formula.     KgMnaOg. 

Derivation.  Permanganate  of  potassium  is  obtained  by  the 
mixture  of  equal  parts  of  black  oxide  of  manganese  and 
chlorate  of  potassium,  with  a  slight  excess  of  caustic  potassa, 
dissolving  in  water,  and  evaporating  to  dryness,  when  it  is  ex- 
posed to  a  nearly  red  heat ;  the  chlorate  of  potassium  yields 
oxygen,  which  changes  the  black  oxide  of  manganese  into 
permanganic  acid,  and  this  acid,  combining  with  the  potassa, 
gives  as  a  product  the  permanganate  of  potassium.  It  is  in  the 
form  of  dark,  purple,  slender  prismatic  crystals,  inodorous,  very 
soluble  in  water,  forming  a  solution  of  a  beautiful  lilac  color, 
even  in  very  minute  proportion,  and  with  a  sweet  astringent 
taste. 

Medical  Properties  and  Action.  Permanganate  of  potassium, 
when  taken  internally,  is  supposed  to  oxidize  the  blood.     It  is 


PREMANGANATE    OF    POTASSIUM.  2G3 

a  stimulant,  mild  escharotic,  and  is  a  powerful  disinfectant,  as 
it  has  a  remarkable  power  of  destroying  fetid  odors  from 
organic  sources,  and  proves  useful  in  preventing  the  spread  of 
infectious  disease.  It  yields  up  its  oxygen  readily,  in  the  form 
of  ozone,  and  its  use  depends  upon  this  property.  It  is  in- 
stantly decomposed  on  reaching  the  stomach. 

Therapeutic  Uses.  Permanganate  of  potassium  is  employed 
with  advantage  in  dyspepsia,  flatulence,  excessive  deposition 
of  fat,  uric  acid  diathesis,  acute  rheumatism,  diabetes,  scar- 
latina, petechial  fever,  spinal  meningitis.  Condy's  fluid  is  a 
favorite  preparation  with  some,  for  both  internal  and  external 
use.  The  most  important  uses  for  permanganate  of  potassium 
are  externally,  as  a  deodorizer  and  disinfectant,  to  correct  the 
fetor  of  cancer,  abscesses,  ulcers,  caries  of  bone,  ozaena,  otor- 
rhcea,  gonorrhoea,  leucorrhoea,  ulcerated  sore  throat,  etc.,  in 
the  form  of  injections,  lotions  and  spray.  It  is  also  used 
externally  in  the  treatment  of  diphtheria,  in  the  proportion  of 
a  drachm  of  Condy's  fluid  to  the  ounce  of  water.  In  solu- 
tion, permanganate  of  potassium  is  applied  in  varying  strength, 
according  to  the  effect  desired.  As  a  local  stimulant,  as  well 
as  deodorizer,  it  is  useful  in  chronic  and  indolent  ulcers, 
carbuncles,  hospital  gangrene,  etc.  The  powder  may  be 
sprinkled  on  gangrenous  surfaces.  In  concentrated  solution 
permanganate  of  potassium  acts  as  a  caustic.  A  strong  solution 
is  composed  of  lO  parts  dissolved  in  90  parts  of  water,  and  is 
employed  in  its  full  strength  in  cancerous,  phagedenic  and 
atomic  ulcers.  For  dressing  simple  wounds,  or  as  an  injection 
in  abscesses,  ozsena,  leucorrhoea,  etc.,  half  a  fluid  ounce  of  the 
solution  may  be  added  to  a  pint  of  water ;  in  gangrenous  and 
diphtheritic  wounds  and  scrofulous  ulcers,  a  fluid  ounce  of  the 
solution  to  a  pint  of  water. 

Dose.  Of  Permanganate  of  Potassium  for  internal  use,  gr.  I 
to  gr.  j,  three  times  a  day.  Condy's  Fluid  is  composed  of  32 
grains  of  permanganate  of  potassium  in  one  pint  of  distilled 
water;  half  a  fluid  ounce  contains  i  grain.  Dose  of  Condy's 
Fluid,  TT\,v.  For  external  application,  f5j,  to  water,  f^v  to  x. 
Solution  of  permanganate  of  potassium — Liquor  Potassii  Per- 


264  DENTAL    MEDICINE. 


majigaiiatis,  is  composed  of  64  grains  of  permanganate  of 
potassium  to  one  pint  of  distilled  water.  M.  de  Lacerda  has 
recently  discovered  that  permanganate  of  potassium  is  one  of 
the  most  energetic  antidotes  to  the  venom  of  snakes. 

Dental  Uses.  In  dental  practice  the  permanganate  of  potas- 
sium is  employed  in  the  treatment  of  fetid  and  gangrenous  ulcera- 
tions of  the  mouth,  such  as  cancrum  oris,  foul  abscesses,  ulcera- 
tions of  mucous  membrane  attended  with  fetid  discharges  ;  as  an 
antiseptic  for  decomposing  pulps  of  teeth ;  in  diseases  of  the 
antrum  and  caries  and  necrosis  of  the  maxillary  bones,  Riggs' 
disease,  ulcers  of  the  mouth,  offensive  breath,  etc.  The  pow- 
dered crystals  introduced  into  a  carious  cavity  will  relieve 
odontalgia.  The  stains  of  permanganate  of  potassium  can  be 
removed  by  dilute  muriatic  acid. 

DENTAL  FORMULA. 

F'or   Unhealthy    Ulcers  of  the  Mouth,     For     Ulcers,    Abscesses,     Decomposing 

and  Offensive  Breath.  Pulps  of  Teeth,  etc. 

(J.  W.  White).  R.     Liquoris    Potassii    Per- 

R  .     Potas.  Permanganatis . . .  ^  j  to  i v  manganatis g  j 

Aquas  Destillatse Oj.         M.  Aquse  Destillatae ^vjtoxM. 

SiGNA. — To  be  used  as  a  gargle.  SiGNA. — To  be  used  as  a  gargle  or  as 

For    Gangrenous    Ulceration    of    the         an  injection. 

Month — Cancrum  Oris.  For  Fetid  Perspiration  and  Foul  Breath. 

R .     Potassii  Permanganatis. .gr.  xxx  R .     Potassii  Permanganatis..gr.  j 

Aquae  Destillat^ ^j.        M.  Aquje  Destillatae fgj.      M. 

SiGNA. — Apply  as  a  lotion.  SiGNA. — To  be  used   as  a  lotion  and 

gargle. 

PYRETHRUM— PELLITORY. 

Source.  Pyrethrum  is  a  native  of  the  Mediterranean  coast? 
the  root  of  which  is  the  medicinal  portion — pyrethri  radix,  in 
the  form  of  cylindrical,  wrinkled  pieces,  of  the  size  of  the 
little  finger,  hard  and  brittle,  and  when  dried,  has  little  or  no 
odor.  Externally  it  is  of  an  ash-brown  color,  within  white, 
and  possesses  an  ejitremely  acrid  taste,  with  a  burning  and 
tingling  sensation  over  the  whole  mouth  and  throat,  which 
continues  for  some  time,  and  excites  a  copious  flow  of  saliva. 

Medical  Properties  and  Action.    Pyrethrum  root  is  an  irritant 


QUERCUS    ALBA WHITE    OAK,  265 

and  sialagogue,  and  when  it  is  rubbed  on  the  skin  it  causes 
much  irritation,  and  may  even  excite  inflammation. 

Its  activity  depends  upon  an  acrid  oil  and  a  compound 
resin  called  pyrctlirin.  It  is  rarely  used  internally,  and  only 
as  a  masticatory. 

Therapeutic   Uses.     Pyrethrum   has   been  employed   as  an 
excitantin  paralysis  of  the  tongue  and  muscles  of  the  throat 
relaxed  sore  throat,  spontaneous  salivation,  certain  forms  of 
headache,  for  such  purposes  being  chewed,  or  employed  in 
the  form  of  a  gargle,  in  tincture  or  decoction. 

Dose.  Of  Pyrethrum  as  a  masticatory,  gr.  xx  to  5j.  Tinc- 
TURA  Pyrethri,  Tincture  OF  Pyrethrum,  is  composed  of 
pyrethrum  oiv,  rectified  spirit  Oj. 

Dental  Uses.  Pyrethrum  is  employed  in  dental  practice,  for 
neuralgic  affections  of  the  face,  for  which  it  is  chewed ;  for  the 
relief  of  odontalgia,  in  the  form  of  the  tincture  applied  to  the 
irritable  pulp  on  a  pellet  of  cotton ;  as  a  stimulant  to  the  gums 
and  mucous  membrane  of  the  mouth  in  relaxed  conditions ; 
for  obtunding  sensitive  dentine,  in  the  form  of  a  strong  alco- 
holic extract.  The  ethereal  oil  of  pyrethrum  is  recommended 
as  a  pleasant  and  efficacious  remedy  in  odontalgia,  applied  in 
the  same  manner  as  the  tincture ;  the  fluid  extract  is  also  em- 
ployed as  an  ingredient  for  local  anaesthetic  preparations,  com- 
bined with  chloroform,  ether  and  lavender.    (See  Chloroform.) 

DENTAL   FORMULA. 
For  Relaxed  Conditions  of  Mucous  Mem- 
brane of  Mouth  and  Gums. 

R.     Tinctura  Pyrethri f^iij 

Aquae J^  viij.     M. 

SiGNA. — To  be  used  as  a  stimulant  gargle. 

QUERCUS   ALBA— WHITE   OAK. 

Source.  White  oak,  the  dried  inner  bark  of  w^hich  is  the 
medicinal  portion,  is  a  common  tree  of  the  natural  order 
AvientacecB.  The  bark  has  a  light-brown  color,  fibrous  texture 
and  an  astringent,  bitter  taste.  Its  medicinal  virtues  depend  upon 
the  presence  of  tannic  and  gallic  acids,  and  a  bitter  principle 
i8 


266  DENTAL    MEDICINE. 


known  as  qitercin.  Water  and  alcohol  form  with  it  decoctions 
and  tinctures. 

Medical  Properties  and  Action.  White  oak  bark  is  tonic, 
astringent,  and  antiperiodic.  It  is  principally  used  as  an 
external  application. 

Therapeutic  Uses.  White  oak  bark  is  employed  internally 
in  the  treatment  of  diarrhoea,  dysentery  and  hemorrhoids. 
Externally  in  relaxation  of  the  uvula,  tonsils,  etc. ;  gangrene, 
indolent  ulcers,  leucorrhcea,  atonic  menorrhagia,  fissure  of  the 
anus,  etc.,  etc.,  in  the  form  of  tincture,  and  decoction  as  gargles, 
lotions  and  injections. 

Decoction  of  White  Oak  Bark,  Decoctum  Qiierciis  Albcs, 
is  composed  of  oak  bark,  Sj ;  water,  Oj. 

Dose.  Of  Powdered  White  Oak  Bark,  gr.  xxx  to  gr.  xl. 
Of  the  decoction  the  dose  is  fSss  to  fSj. 

Dental  Uses.  In  dental  practice  the  decoction  and  tincture 
are  employed  externally  in  the  various  forms  of  stomatitis, 
sponginess  of  the  gums,  relaxed  condition  of  the  mucous 
membrane  of  the  mouth  and  fauces. 

QUILLAYA   SAPONARIA— QUILLAIA   BARK. 
South  Am.  Soap  Tree  Bark. 

Source.  Quillaia  bark  is  obtained  from  an  evergreen  tree 
of  the  natural  order  Roseacecs — rose  order,  growing  in  Chili 
and  Peru,  the  inner  bark  being  employed. 

Medical  Properties  and  Action.  Quillaia  bark  when  bruised 
and  macerated  in  water,  imparts  to  that  liquid  the  property  of 
frothing  like  soap  solution  when  agitated,  which  is  owing  to 
the  saponaria  in  the  bark,  the  same  principle  which  imparts  a 
similar  property  to  soapwort — sapo7iaria  officinalis.  Quillaia 
contains  no  tannic  acid  or  other  bitter  principle,  and  is  an 
article  of  commerce,  being  imported  in  large  quantities  for 
cleansing  grease  from  cloth,  as  it  does  not  change  the  color 
of  silken  or  woolen  goods ;  it  is  also  used  for  cleansing  the 
hair,  which  it  is  supposed  to  preserve  and  beautify.  When 
the  powder  is  snuffed  up  the  nostrils,  it  causes  sneezing  and 
a  profuse  nasal  discharge. 


QUILLAYA    SAPONARIA QUILLAIA    BARK. 


267 


TJicrapaitic  Uses.  Quillaia  bark  has  been  employed  as  a 
febrifuge,  to  arrest  excessive  secretion,  as  an  application  to 
ulcers,  as  a  remedy  for  colds  in  the  head,  when  it  is  used  as 
a  sternutatory,  in  the  form  of  powder. 

The  tincture  is  composed  of  quillaia  bark  i  part,  alcohol 
5  parts ;  it  is  also  used  in  the  form  of  infusion  and  fluid 
extract. 

Dental  Uses.  Quillaia  bark,  in  the  form  of  powder,  tincture 
and  fluid  extract,  is  employed  as  an  ingredient  of  mouth- 
washes, for  its  frothy  and  detergent  properties ;  it  is  also  used 
as  an  application  to  chronic  ulcers  of  the  mouth,  and  to  arrest 
excessive  secretion  of  the  mucous  membrane  of  the  mouth. 


DENTAL   FORMULA. 


Detergent  Mouth  Wash. 
(Am.  Journ.  Pharm.) 
R .     Pulv.  Potassii  Bicarbon- 

atis ^ss 

Mellis giv 

Alcoholis gij 

Olei  Caryophilli q.  s 

Olei  Gaultherise, 
Quillaiae  Saponarise  (fluid 

ext.) ^] 

Aquse  Destillatse ^ix.    M. 

To  be  used  after  the  removal  of  sali- 
vary calculus. 

Fo?'  a  Mouth  Wash. 
R .     Pulv.   Quillaise  Sapona- 

rise ^iv 

Glycerini giij 

Alcoholus  dialutus  suffi- 
cient for  2  pints. 

Olei  Gaultherise gtt.  xx 

Olei  Menthae gtt.  xx  M. 

Macerate  the  soap  bark  in  the  mix- 
ture of  glycerine  and  alcohol  for  3  days, 
and  filter  through  a  little  magnesia  pre- 
viously triturated  with  the  volatile  oils. 


For  Inflamed  Gums  and  Mucous 

Membrane. 

(Chapin  a.  Harris.) 

R .     Quillaise  Saponarise ^  viij 

Pyrethri, 
Radicis  Iridis, 
Acidi  Benzoici, 

Cinnamon aa ^^j 

Acidi  Tannici ^^iv 

Sodii  Boratis g  iv 

01ei_Gaultheri£e f^ij 

Olei  Menthae f^iy 

Cochineal ^iij 

Sacchari   Albi Ibj 

Alcoholis Oiij 

Aquae  purse Ov.     M 

Digest  for  6  days  and  filter. 
SiGNA. — To  be  used  as  a  gargle. 


268  DENTAL   MEDICINE. 


QUININE  SULPHAS— SULPHATE  OF  QUININE. 

Formula.     C20H24N2O2,  3H2O. 

Derivation.  The  two  important  alkaloid  principles  of  Cin- 
chona are  quinia  and  cinchonia,  which  exist  in  combination 
with  kinic  2.z\<\.     (See  Cinchona.) 

Sulphate  of  quinine  is  obtained  by  boiling  the  powdered 
yellow  cinchona  bark  in  water  acidulated  with  hydrochloric 
acid,  by  which  the  alkaloid  quinine  is  separated  from  kinic 
and  other  acids  and  forms  a  soluble  hydrochlorate  or  muriate, 
the  salt  being  decomposed  and  the  quinine  precipitated  by  the 
addition  of  lime ;  sulphuric  acid  is  added,  after  digestion  in 
boiling  alcohol,  which  dissolves  the  quinine,  and  the  solution 
is  boiled  with  animal  charcoal,  filtered  and  allowed  to  crystal- 
lize. Sulphate  of  quinine  is  in  the  form  of  colorless,  very 
light  and  silky  crystals,  which  are  readily  soluble  in  alcohol 
and  in  water  acidulated  with  sulphuric  acid,  but  insoluble  in 
ether.     It  has  an  intensely  bitter  taste,  and  is  inodorous. 

Medical  Properties  and  Action.  Sulphate  of  quinine  is  a 
very  valuable  tonic  and  antiperiodic,  also  antiseptic  and  stimu- 
lant. In  small  doses  it  increases  the  fullness  of  the  pulse  and 
action  of  the  heart,  and  improves  the  tonicity  of  the  capillary 
vessels,  and  is  diffused  into  various  parts  of  the  system  with 
great  rapidity.  In  large  doses  it  depresses  the  action  of  the 
heart,  lowers  the  blood-pressure,  and  enfeebles  as  well  as 
diminishes  the  beats  of  the  pulse.  As  it  accumulates  in  the 
brain,  it  causes  a  fullness  in  the  head,  a  constricted  feeling 
about  the  forehead,  a  buzzing  or  ringing  in  the  ears — tinnitus 
aurium,  giddiness,  vertigo,  and  deafness,  which  may  be  perma- 
nent if  the  agent  is  taken  in  excessive  quantity ;  also  amaurosis 
and  amblyopia  may  be  caused  by  full  doses.  Poisonous  doses 
cause  intense  headache,  dilated  pupils,  delirium,  coma  and 
convulsions.  Some  five  hours  are  required  to  bring  about  the 
greatest  effect  of  quinine,  although  it  can  be  detected  in  the 
urine  in  about  half  an  hour  after  it  is  taken  into  the  stomach, 
and  elimination,  chiefly  by  the  kidneys,  is  not  completed  in 


OUININ,^    SULPHAS SULPHATE    OF    QUININE.  269 

a  less  time  than  48  hours,  although  the  principal  portion  is 
excreted  in  12  hours. 

Therapeutic  Uses.  Quinine  is  extensively  employed  in  pe- 
riodical diseases  of  a  malarial  origin,  such  as  intermittent  fever, 
neuralgia  of  various  forms,  as  enteralgia,  hepatalgia,  nephralgia, 
gastralgia,  sciatica,  angina  pectoris,  and  in  cases  of  debility» 
pneumonia,  pleurisy,  endocarditis,  pyaemia,  erysipelas,  puer- 
peral fever,  cerebro-spinal  meningitis,  eruptive  fevers,  etc.,  etc. ; 
but  the  most  important  uses  of  quinia  are  for  the  treatment 
of  malarial  diseases. 

Dose.  Of  Sulphate  of  Quinine,  gr.  j  to  3j,  in  aromatic  water, 
by  the  aid  of  aromatic  sulphuric  acid,  and  also  as  an  enema,  or 
hypodermically.  Pills  may  be  made  by  combining  24  grains 
of  sulphate  of  quinine  with  14  grains  of  clarified  honey,  and 
dividing  into  24  pills.     Pills  can  also  be  made  with  glycerine. 

Dental  Uses.  Sulphate  of  quinine  is  internally  employed  in 
dental  practice  in  the  treatment  of  facial  and  other  neuralgic 
affections,  in  cancrum  oris,  for  its  tonic  and  stimulant  effects, 
in  aphthous  ulcerations  of  the  mouth  and  in  scurvy,  where 
the  system  is  much  debilitated,  and  externally  as  an  ingredient 
of  dentifrices,  for  its  tonic  and  stimulant  properties. 

QuiNiNyE  Hypophosphis — Hypophosphite  of  Quinine. 

Formula.     C22H24NO4PH2O2. 

Derivation.  Hypophosphite  of  quinine  is  obtained  by  dis- 
solving quinine  in  hypophosphorous  acid,  or  by  decomposing 
sulphate  of  quinine  with  hypophosphite  of  baryta,  filtering  and 
evaporating  the  solution. 

Medical  Properties  and  Action.  Same  as  those  of  sulphate 
of  quinine,  but  not  so  powerful  in  its  action. 

Therapeutic  Uses.  Hypophosphite  of  quinine  is  used  in  all 
cases  where  the  hypophosphites  are  indicated,  and  its  action  is 
milder,  on  account  of  its  containing  less  acid.  It  is  employed 
as  an  antiperiodic,  and  is  especially  adapted  for  the  treatment 
of  children  during  the  period  of  dentition  when  it  is  accom- 
panied with  emaciation,  loss  of  appetite  and  strength,  and 
when  convulsions  are  threatened. 

Dose.     Of  Hypophosphite  of  Quinine,  gr.  j  to  gr.  iij. 


270  DENTAL    MEDICINE. 


DENTAL   FORMULA. 
For  Facial  Neuralgia  from  Dental      For  Neuralgia  frotn  Dental  Disturb- 
Disturbance.  ance. 

Barrett.  L.  De  L.  Gorgas. 

R.     Ferri  et  Quin.  (cit) gij  R.     Quininse  Sulphatis gr.  x 

Syrup  Aurantii ^j  Ferri  Sulphat.  Exsic gr.  v 

Aqua  Dest ^j  Acidi  Arseniosi gr.  ss 

Elixir  Calisayae 5ij.       M.  Ext.  Nucis  Vomicas gr.  v. 

SiGNA. — Coch.  Parv.  ter  in  die.  M.  ft.  pil.  No.  xx. 

SiGNA. — One  pill  every  four  hours. 

For  Neuralgia  Associated  with  Ancemia. 

Garretson. 
R .     Tinct.  Ferri  Chloridi....  gj 

Quininse  Sulphatis |^j.        M. 

SiGNA. — Teaspoonful  four  times  daily. 

RHIGOLENE— RHIGOLENE. 

Derivation.  Rhigolene  is  a  product  of  the  distillation  of 
petroleum.  In  its  composition  it  is  a  hydro-carbon,  and  is 
destitute  of  oxygen,  being  extremely  volatile  and  inflammable, 
and  is  the  lightest  of  all  liquids,  with  a  specific  gravity  of 
0.625.  It  is  a  petroleum  naphtha,  and  boils  at  70°  F.,  and 
when  perfectly  pure  should  be  almost  odorless ;  but  it  is 
difficult  to  procure  any  specimen  that  does  not  have  the  un- 
pleasant odor  of  petroleum.  It  is  colorless,  and  on  account 
of  its  great  volatility  and  inflammability  requires  to  be  kept 
tightly  stopped,  in  a  cool  place.  The  storage  of  large  quan- 
tities, except  in  very  secure  places,  is  attended  with  considerable 
risk,  and  on  this  account  it  is  somewhat  difficult  to  procure  it 
outside  of  the  manufactories.  It  is  dangerous  to  use  it  at 
night,  or  near  a  light. 

Dental  Uses.  Rhigolene  is  employed,  like  absolute  ether, 
to  produce  local  anaesthesia,  by  dispersing  it  in  the  form  of 
spray,  with  the  spray  apparatus,  being  the  most  rapid  in  its 
congealing  effects,  and  also  the  mo^t  easily  controlled  and  con- 
venient of  all  of  the  freezing  mixtures.  As  a  local  anaesthetic 
it  is  employed  in  the  operation  of  extracting  teeth,  by  apply- 
ing it,  in  the  form  of  spray,  to  the  parts  about  the  tooth  to  be 
removed  until  a  blanched  surface  of  gum  is  produced.     The 


SANDARACA SANDARACH.  271 

spray  of  rhigolene  is  also  applied  to  the  gum  over  the  root 
of  a  tooth  affected  with  incipient  periostitis. 

SANDARACA— SANDARACH. 

Source.  Sandarach  is  a  resinous  substance  obtained  from  an 
evergreen  tree — Thuya  Articulata — which  grows  in  the  north- 
ern part  of  Africa.  The  gum  is  in  the  form  of  small,  irregu- 
lar, round  and  oblong  tears,  of  a  pale  yellow  color,  sometimes 
brown,  and  more  or  less  transparent,  dry  and  brittle.  It  has  a 
faint,  agreeable  odor,  which  is  increased  by  warmth,  and  a 
resinous,  somewhat  acrid  taste.  It  melts  with  heat,  diffusing 
a  strong  balsam  odor,  and  is  inflammable.  It  is  soluble  in  al- 
cohol and  ether,  and  slowly  dissolves  in  warm  oil  of  turpentine. 
It  consists  of  three  resins,  varying  in  their  relations  to  alcohol, 
ether,  and  oil  of  turpentine.  The  sandaracin  which  remains 
after  sandarach  has  been  exposed  to  the  action  of  ordinary 
alcohol  is  a  mixture  of  two  of  these  resins. 

Uses.  Sandarach  was  formerly  employed  as  a  medicinal 
agent,  and  entered  into  the  composition  of  various  ointments 
and  plasters,  but  its  use  is  now  restricted  to  such  purposes  as 
the  composition  of  a  varnish,  ingredient  of  incense,  etc.  After 
the  erasion  of  ink  marks,  its  powder,  if  rubbed  on  such  a  sur- 
face, will  prevent  fresh  ink  marks  from  spreading. 

Dental  Uses.  In  dental  practice,  sandarach  dissolved  in 
alcohol  forms  a  varnish  for  coating  the  surface  of  plaster 
models,  etc. ;  it  is  also  used  for  checking  secretions  from  the 
gums  during  the  operation  of  filling  teeth,  either  applied  as  a 
coating  to  the  surface,  or  on  bibulous  paper  saturated  with  it. 
It  is  also  employed  to  saturate  cotton  to  be  used  as  a  tempo- 
rary filling  in  cavities  of  the  teeth,  for  the  protection  of  medi- 
cinal applications. 

DENTAL  FORMULA. 
Transparent  Sandarach   Varnish. 

R.     Gum  Sandarach ^v 

Alcohol qt.  j. 

Mix  and  digest  over  a  moderate  heat 
until  the  sandarach  is  dissolved. 


272  DENTAL   MEDICINE. 


SHELL-LAC— SHELLAC. 

Source.  Lac  is  a  resinous  substance,  obtained  from  several 
varieties  of  trees  which  grow  in  the  East  Indies,  and  particu- 
larly from  the  Croton  Lacciferum,  and  two  species  of  the  Fiats. 
It  is  supposed  to  be  an  exudation  from  the  bark,  owing  to  the 
puncture  of  an  insect  belonging  to  the  genus  Coccus  ;  it  is  also 
said  to  be  the  exudation  from  the  bodies  of  the  insects  them- 
selves. Several  varieties  are  known  in  commerce,  the  most 
common  being  the  stick-lac,  the  seed-lac  and  the  shell-lac.  Lac, 
in  its  crude  state,  consists  of  resin,  coloring  matter,  and  a 
peculiar  principle,  insoluble  in  water,  alcohol  or  ether,  and 
known  as  lacin,  a  little  wax,  and  various  saline  matters  in  small 
proportion. 

Uses.  It  is  slightly  astringent,  and  has  been  recommended 
as  an  adhesive  substance  for  dressing  ulcers,  wounds,  etc.,  being 
used  by  simply  spreading  it  on  the  bandages  after  it  is  dis- 
solved in  alcohol  by  a  gentle  heat.  Shellac  is  prepared  by 
melting  the  crude  lac,  straining  it,  and  pouring  it  upon  a  flat, 
smooth  surface,  to  harden.  It  is  in  the  form  of  thin  fragments 
of  various  sizes,  from  half  a  line  to  a  line  in  thickness,  and  of 
a  light  and  also  dark  brown  color,  shining,  hard,  brittle  and  in- 
odorous. It  is  insoluble  in  water,  but  freely  soluble  in  alcohol, 
especially  with  the  aid  of  heat.  It  is  employed  as  a  varnish. 
In  dental  practice  its  uses  are  the  same  as  those  of  sandarach, 
but,  owing  to  the  dark  brown  color  of  the  solution,  it  is  not  so 
sightly,  and  does  not  make  a  transparent  varnish. 

DENTAL   FORMULA. 
For  a  Colored  Varnish. 

R.     Gum  Shellac ,^  v 

Alcohol qt.  j. 

Mix  and  digest  over  a  moderate  heat 
until  thoroughly  dissolved. 


SOD/E    PHENAS — PHENATE    OF    SODIUM.  273 

SOD^  PHENAS— PHENATE  OF  SODIUM. 
Carbolate  of  Sodium. 

Formula.     NaCgHgO. 

Derivation.  Phenate  or  carbolate  of  soda  is  obtained  by 
mixing  caustic  soda  with  carbolic  acid  and  a  small  quantity 
of  water,  and  evaporating  the  solution,  the  result  being  a 
saponaceous  mass  of  acicular  crystals  of  a  light  pinkish 
color,  which  are  converted  by  heat  into  a  flui^  of  an  oily 
consistence.  It  is  freely  soluble  in  creasote,  carbolic  acid 
and  water. 

Medical  Properties  and  Action.  Phenate  of  soda  is  haemo- 
static, antiseptic  and  disinfectant. 

Therapeutic  Uses.  It  is  internally  administered  in  the  form 
known  by  the  French  name  of  Phenol  Sodigue,  in  doses  of  gtt. 
viij  or  gtt.  X  in  a  glass  of  water  in  typhus  and  typhoid  fevers, 
as  a  preventive  of  cholera,  in  plagues,  cholera  infantum, 
etc. ;  externally  it  is  a  valuable  styptic  in  local  hemor- 
rhage, and  as  a  dressing  for  wounds,  burns,  chilblains,  excori- 
ations, varicose  veins,  venomous  stings  and  bites,  and  as  a  dis- 
infectant in  throat  affections,  leucorrhoea,  diphtheria,  scarlatina* 
smallpox,  ozaena,  etc. 

Dental  Uses.  Phenate  of  soda  is  useful  in  dental  practice,  as 
an  astringent  and  styptic  in  hemorrhage  following  the  extraction 
of  teeth,  and  to  relieve  the  soreness  of  such  an  operation,  as 
it  promotes  the  rapid  absorption  of  the  extravasated  blood,  and 
the  healing  and  hardening  of  the  gums.  It  is  applied  on  a 
pellet  of  cotton,  or  in  solution  with  water,  and  acts  as  a  seda- 
tive and  antiphlogistic  as  well  as  a  haemostatic,  and  has  little  or 
no  escharotic  action.  For  soft  and  spongy  gums  it  forms  an 
efficient  gargle  or  mouth  wash,  and  can  be  employed  for  this 
purpose  in  its  full  strength,  in  the  form  of  phenol  sodique,  or 
diluted  with  from  one  to  twelve  parts  of  water.  When  applied 
on  cotton,  to  an  exposed  and  inflamed  pulp,  it  relieves  odontal- 
gia. It  is  also  employed  in  aphthous  ulcerations  of  the  mouth, 
and  as  a  disinfectant  in  offensive  breath,  in  the  proportion  of  a 
teaspoonful  to  a  glass  of  water. 


274  DENTAL   MEDICINE. 


DENTAL  FORMULA. 
A  Phenol  Sodique  Preparation. 

R.     Acidi  Carbolic! grs.  clxxxviij 

Sodse  Caustic grs.  xxxj 

Aquffi 5  iv.       M. 

SiGNA. — To  be  applied  on  a  pellet  of 
cotton,  or,  as  a  mouth  wash,  diluted 
to  meet  requirements  of  case. 

SODII  BICARBONAS— BICARBONATE  OF  SODIUM. 

(Sesquicarbonate  of  Sodium.) 

Formula.     NaHCOg. 

Derivation.  Bicarbonate  of  sodium  is  obtained  by  saturating 
the  carbonate  of  sodium  with  carbonic  acid.  It  is  in  the  form 
of  a  white,  opaque  powder,  freely  soluble  in  water,  with  a  mild, 
slightly  alkaline  taste. 

Medical  Properties  and  Action.  Bicarbonate  of  sodium  is 
antacid,  alterative  and  lithontriptic,  and  from  its  mildness  and 
non-irritating  qualities  is  more  pleasant  to  the  taste  and  to  the 
stomach  than  the  carbonate.  It  is  extensively  used  in  the 
preparation  of  soda  and  seidlitz  powders. 

Therapeutic  Uses.  Bicarbonate  of  sodium  is  internally  ad- 
ministered in  neuralgia  connected  with  acidity  of  the  stomach, 
cardialgia,  flatulence  and  vomiting,  dyspepsia,  diarrhoea,  dis- 
eases of  the  skin,  albuminuria,  calculous  disease,  etc.  Ex- 
ternally in  diseases  of  the  skin  of  a  scaly  and  papular  nature, 
ecthyma,  ringworm,  and  sprinkled  over  burns  and  scalds,  and 
combined  with  an  equal  part  of  common  salt,  for  stings  of 
venomous  insects. 

Dose.  Of  Bicarbonate  of  Sodium,  gr.  v  to  5j,  in  carbonic 
acid  water,  or  with  sugar  and  mucilage. 

Effervescing  Powders — Pulveris  Effervescentes,  are  com- 
posed of  tartaric  acid,  gr.  xxv  in  one  paper,  and  bicarbonate 
of  sodium,  gr.  xxx  in  another  paper. 

Dental  Uses.  Bicarbonate  of  sodium  is  employed  in  dental 
practice,  to  relieve  neuralgia  of  an  acid  origin,  in  which  a  full 
dose  often  proves  very  serviceable  ;  in  aphthae  of  children  it  is 
often  combined  with  a  little  rhubarb  and  proves  very  efiicacious. 


SODII    BORAS BORATE    OF    SODIUM.  275 


Externally  it  relieves  odontalgia  when  a  small  portion  of  the 
powder  is  applied  to  the  irritable  pulp.  It  is  also  useful  for 
neutralizing  the  acidity  of  the  oral  fluids,  especially  when  such 
a  condition  is  the  result  of  pregnancy.     It  also  forms  an  ant- 


acid ingredient  in  dentifrices. 


SODII   BORAS— BORATE   OF   SODIUM. 
(Borax.) 

Formula.     2NaB02,  2HBO2,  9H2O. 

Source.  Borax  is  a  native  salt,  but  can  be  obtained  arti- 
ficially by  boiling  together  native  boracic  acid  (found  in  Italy), 
and  carbonate  of  soda.  California  furnishes  the  borax  used 
in  this  country.  It  is  in  the  form  of  colorless  crystals,  which 
effloresce  somewhat  in  dry  air,  and  are  freely  soluble  in  water 
and  glycerine,  but  insoluble  in  alcohol,  with  an  alkaline  re- 
action, and  a  sweetish,  alkaline  taste.  It  dissolves  fibrine, 
albumen,  casein  and  uric  acid. 

Medical  Properties  and  Action.  Borax  is  refrigerant,  diuretic, 
detergent,  antacid  and  emmenagogue,  and  has  been  employed 
as  a  solvent  for  calculi.  It  resembles  in  its  action  carbonate 
of  soda,  and  by  its  mild  alkaline  qualities  it  improves  the 
condition  of  the  skin  and  mucous  membranes.  In  excessive 
or  large  repeated  doses  it  is  injurious,  causing  nausea  and 
vomiting,  and  a  scorbutic  condition  of  the  body. 

Therapeutic  Uses.  Borax  is  internally  administered  in  infan- 
tile diarrhoea,  in  the  form  of  an  enema  ;  also  as  a  solvent  for 
calculi,  and  in  dropsy,  etc.,  but  its  chief  use  is  as  an  external 
application.  Externally  it  is  applied  as  a  detergent  in  cutaneous 
affections,  ulcerations,  pityriasis,  to  remove  freckles,  to  allay 
itching,  etc.,  etc. 

Dose.     Of  Borate  of  Sodium,  gr.  ij  to  3j. 

Glycerite  of  Borate  of  Sodium — Glyceritum  Sodii  Bora- 
tis — Glycerinum  Boracis — is  composed  of  borax,  Sij  ;  glycerine, 
Oss,  and  is  a  useful  application  to  the  mouth  and  throat. 

Honey  of  Borate  of  Sodium — Mel  Sodii  Boratis — Mel 
Boracis — is  composed  of  borax,  5j  ;  clarified  honey,  Sj,  and 


276  DENTAL    MEDICINE. 


is  also  useful  as  a  detergent  application  to  the  mouth  and 
throat. 

Dental  Uses.  Borax,  mixed  with  sugar  or  honey,  is  a  very- 
useful  application  for  aphthae  and  other  ulcerations  of  the 
mouth,  for  which  it  may  be  mixed  with  sugar  in  the  propor- 
tion of  one  part  to  seven,  or  in  the  form  of  mel  boracis.  In' 
mercurial  stomatitis,  an  aqueous  solution  of  borax,  or  the  mel 
boracis,  forms  an  efficient  gargle.  Borax  is  also  a  useful  appli- 
cation in  fissured  or  cracked  tongue.  Borax  is  also  added  to 
sage  and  balm  teas,  to  form  gargles. 

In  the  dental  laboratory,  borax  is  employed  as  a  flux  in 
melting  metals,  such  as  gold  and  silver,  and  in  the  process  of 
soldering  metals.  It  is  also  employed  to  harden  plaster  casts 
or  models,  the  model  being  well  dried  and  then  immersed  for 
a  few  minutes  in  a  solution  of  borax  in  boiling  water,  which 
renders  it,  when  cool,  hard  and  durable.  (Solutions  of  carbon- 
ate of  soda  and  alum  are  used  for  the  same  purpose.) 

DENTAL  formula; 
A  Mild  Detergent  Gargle.  For  Fissured  Tongue. 

R.     Sodii  Biboratis J^]  (J.  W.  WnrrE.) 

Glycerini g  vj        M.     R.     Sodii  Biboratis gr.  xl 

Glycerini _^  j 

For  Fissured  or  Cracked  Tongue,  Aquse  Destillatse ^  i^-      ^• 

R.     Sodii  Biboratis ^j  To  be  used  as  a  gargle. 

Glycerini ^j.        M. 

To  be  used  as  a  lotion  or  gargle.  A  Detergent  Alkaline  Gargle. 

R.     Sodii  Biboratis ^iv 

For   Aphthous    Ulcerations,    Parasitic  Glycerini, 

Formations,  and  Diphtheritic    Con-  Tincturae  Myrrh3e...aa,..,^  ss 

ditions.  Aquae  Destillatae Jx.       M. 

R  .     Sodii  Hyposulphitis 3  ij 

Syrupi  Auranti ^iv  For  Aphthous  Ulcerations,  etc.,  etc. 

Aquae  Destillatse ^iv.     M.     R.     Sodii  Sulphitis ^j 

SiGNA. — To  be  applied  as  a  lotion  or  Glycerini ^j.       M, 

mouth  wash,  stimulant  and  antiseptic.     Signa. — To  be  used  as  a  lotion  or  mouth 

wash. 


TERCHLORIDE    OF    PHENOL.  277 

TERCHLORIDE   OF   PHENOL. 

Derivation.  Terchloride  of  phenol  has  recently  been  intro- 
duced as  a  disinfectant  and  antiseptic.  It  is  prepared  by 
passing  a  stream  of  chlorine  gas  through  chemically  pure  car- 
bolic acid,  previously  melted,  until  it  acquires  a  violet  hue. 

Medical  Properties  and  Action.  It  is  not  an  irritant  and  has 
no  acid  reaction.  When  carbolic  acid  is  acted  upon  by  chlorine 
gas  a  number  of  compounds  are  produced ;  such  as  a  mono- 
chloride,  a  bichloride,  and  a  tri-  or  ter-chloride  of  carbolic 
acid  (phenol). 

Therapeiitic  and  Dental  Uses.  Terchloride  of  phenol  is 
claimed  to  be  a  valuable  antiseptic  and  disinfectant  in  the 
treatment  of  gangrenous  ulcers,  etc.  In  dental  practice  it  has 
been  very  recently  recommended  in  combination  with  iodoform, 
as  a  material  for  capping  exposed  pulps  and  as  a  filling  for 
root  canals  of  teeth,  and  the  advantages  claimed  for  it  are, 
that  it  will  be  resorbed  when  in  contact  with  living  tissues  ; 
it  is  easily  introduced  into  pulp  canals ;  it  absorbs  exudations ; 
it  becomes  hard  when  mixed  with  certain  chemical  substances, 
but  is  destroyed  by  pus ;  it  is  a  very  bad  conductor  of 
heat ;  and  it  is  absolutely  a  non-irritant.  The  method  recom- 
mended for  its  use  as  a  capping  and  filling  material,  is  to 
incorporate  the  iodoform  and  terchloride  of  phenol  with  de- 
calcified dead  bone,  as  follows :  dead  bone  or  ivory  shavings 
are  decalcified  in  a  ten  per  cent,  solution  of  chemically  pure 
hydrochloric  acid,  and  after  all  the  lime  salts  are  extracted, 
the  residue  is  collected  upon  a  filter,  washed,  dried  and  rubbed 
to  a  fine  powder  in  a  porcelain  or  glass  mortar.  Upon  this 
powder  ten  times  its  weight  of  a  ten  per  cent,  solution  of 
iodoform  in  sulphuric  ether  is  gradually  poured  and  constantly 
rubbed  until  a  fine  yellow  powder  is  obtained,  which  contains 
about  fifty  per  cent,  of  iodoform.  When  used  as  a  capping 
for  pulps,  or  a  filling  material  for  root  canals  of  teeth,  this 
powder  is  made  into  a  paste  by  the  addition  of  carbolic  acid 
or  terchloride  of  phenol,  being  worked  or  rubbed  together  like 
ordinary  cement.     For  hyperaemic  conditions  of  the  dental 


278  DENTAL    MEDICINE. 


pulp  success  has  attended  the  apphcation  of  a  cap  of  the 
iodoform  and  decalcified  bone  paste  mixed  with  terchloride  of 
phenol.  For  inflamed  pulps  the  application  of  terchloride  of 
phenol  is  to  be  repeated  every  third  or  fifth  day,  until  no  more 
pain  is  felt,  and  the  pulp  is  then  to  be  capped  with  the  de- 
calcified bone,  iodoform  and  terchloride  of  phenol  material, 
and  a  temporary  filling  introduced  into  the  crown  cavity. 
The  treatment  of  ulcerated  and  gangrenous  pulps  of  teeth 
consists  in  treating  with  the  terchloride  of  phenol,  and  after 
the  second  or  third  application,  if  no  trouble  occurs  from  a 
temporary  closure  of  the  root  canals,  to  fill  with  the  decalcified 
bone,  iodoform  and  terchloride  material,  using  whalebone  in- 
struments for  its  introduction,  until  congelation  is  occasioned, 
and  the  congested  condition  of  the  capillaries  of  the  part  re- 
lieved, acting  as  a  counter-irritant  and  antiphlogistic. 

THYMOL— THYMOL. 

Formula.     C10H14O. 

Derivation.  Thymol,  or  thymic  acid,  is  obtained  from  the 
herb  thymus  vulgaris,  or  common  thyme,  which  is  cultivated 
in  this  country  for  the  same  purpose  as  sage,  lavender,  etc. 
Thyme  yields  a  volatile  oil,  oleum  thymi,  from  which  thymol 
or  thymic  acid  is  obtained  by  treating  the  oil  with  an  aqueous 
solution  of  potassa  or  soda,  which  separates  it  from  a  principle 
called  thymene,  with  which  it  is  mixed  in  the  oil,  and  which  is 
not  affected  by  the  alkalies.  The  thymate  thus  formed  is  de- 
composed by  an  acid,  and  the  liberated  thymol  or  thymic  acid 
is  purified  by  repeated  washings,  dessication  and  distillation. 
Thymol  is  in  the  form  of  aromatic  white  crystals,  soluble  in 
one  thousand  parts  of  hot  water. 

Medical  Properties  and  Action.  In  a  concentrated  state, 
thymol  has  an  acrid  and  caustic  taste,  but  when  very  much 
diluted,  the  only  taste  experienced  is  that  of  thyme. 

Thymol  has  acid  properties,  and  is  similar  in  its  action  to 
carbolic  acid.  It  imparts  a  sense  of  coolness  to  the  mouth,  like 
that  of  oil  of  peppermint,  and  when  once  melted  it  remains 
indefinitely  in  the  liquid  state. 


THYMOL THYMOL.  279 


While  it  is  only  slightly  soluble  in  water,  it  is  freely  soluble 
in  alcohol,  and  is  dissolved  by  ether  and  the  fixed  oils.  The 
alkalies  unite  with  it  to  form  soluble  salts.  Like  creasote,  it 
has  the  property  of  combining  with  animal  tissues,  and  thus 
prevents  putrefaction.  While  it  has  the  important  practical 
properties  of  carbolic  acid,  it  is  free  from  disagreeable  odor, 
and  it  is  claimed  to  be  as  efficient  an  antiseptic  as  that 
agent. 

Therapeutic  Uses.  Thymol  is  almost  exclusively  employed 
as  an  external  application,  and  is  often  substituted  for  the  oil 
of  origanum,  which  is  obtained  from  the  common  majoram.  It 
is  considered  to  be  a  valuable  antiseptic  and  antifermentative 
agent. 

Dental  Uses.  Thymol,  when  combined  with  glycerine,  in  a 
form  known  as  Glycerole  of  Thymol,  is  a  valuable  antiseptic 
in  the  treatment  of  suppurating  pulps  of  teeth,  as  a  dressing 
for  ulcers  of  the  mouth,  wounds,  etc. ;  also  in  the  treatment 
of  teeth  after  the  devitalization  of  the  pulp,  chronic  inflamma- 
tion of  the  pulp,  and  alveolar  abscess,  as  it  arrests  the  putre- 
factive process ;  also  in  stomatitis  and  abrasion  of  mucous 
membrane. 

DENTAL  FORMULA. 
Glycerole  of  Thymol.  For  Stomatitis. 

R.     Thymolis  (cryst.) gr-  xx  (Alvin.) 

Glycerini,  R.     Thymolis   (cryst.) ptm.  j 

Alcoholis aa  f^  j  Glycerini pts.  loo. 

Aquae  Destillatse Oj.         M.     Signa. — To   be   used   as  a  lotion   and 

gargle. 
For    Alveolar     Abscess,    Suppurating 

Pulps,  etc.  For    an     Antiseptic    in    Suppurating 

(Alvin.)  Pulps,  Alveolar  Abscess,  etc. 

R.     Thymolis   (cryst.) ptm.  j  R.     Thymolis  (cryst.) ptm.  i 

lodi ptm.  j  Glycerini pts.  ij  toiv. 

Potassii  lodidi ptm.  j         •    Signa. — Applied   in   same  manner   as 

Glycerini pts.  v  toxv         carbolic  acid. 

Apply  as  in  use  of  carbolic  acid. 


280  DENTAL   MEDICINE. 


VASELIN— VASELINE. 
Petroleum  Ointment. 

Derivation.  Vaseline  is  obtained  from  crude  petroleum,  in 
the  form  of  a  petroleum  jelly.  In  the  distillation  of  crude 
petroleum  there  remains  in  the  apparatus,  after  the  separation 
of  the  light  oils,  a  semi-liquid  tar,  which  constitutes  crude 
vaseline,  which,  in  such  a  state,  has  a  disagreeable  odor  like 
petroleum,  of  a  strong  taste  and  black  color.  This  compound 
is  heated  in  the  open  air,  and  decolorized  by  animal  charcoal, 
the  product  being  the  petroleum  jelly  known  as  vaseline,  which 
is  a  mixture  of  several  hydrocarbons. 

When  pure,  vaseline  is  white,  inodorous  and  insipid,  and  of 
the  consistence  of  jelly,  or  very  unctuous  fat.  It  melts  at  35° 
C,  boils  at  150°  C,  and  distills  at  200°  C,  and  burns  without 
residue.  Exposed  for  a  considerable  time  to  light,  it  acquires 
a  slight  odor  of  petroleum.  It  is  insoluble  in  water,  sparingly 
soluble  in  alcohol,  and  very  soluble  in  warm  ether,  chloroform, 
fats,  volatile  oils,  and  sulphide  of  carbon.  It  sensibly  dissolves 
iodine,  bromine,  sulphur,  phosphorus,  carbolic  acid,  benzoic 
acid,  atropine  and  strychnine. 

Medical  Properties  and  Action.  By  its  composition,  vaseline 
is  not  capable  of  becoming  rancid,  nor  of  being  saponified  ; 
hence  it  is  a  very  useful  agent  or  excipient  for  caustic  alkalies, 
oxides,  metallic  salts,  and  even  acids  in  the  cold,  without 
action  by  them,  and  without  modifying  their  therapeutic  prop- 
erties. Incorporated  in  ointments,  a  certain  quantity  of  vase- 
line will  preserve  them  and  obviate  rancidity,  being  preferable 
to  lard,  butter,  glycerine  and  glyceroles.  The  addition  of  par- 
affin will  give  it  any  consistence  desired. 

Therapeutic  Uses.  Vaseline  :|^s  used  externally  as  a  dressing 
for  wounds,  cuts,  bruises,  sprains,  piles,  rheumatism,  skin  dis- 
eases, eczema,  inflamed  surfaces,  diseases  of  the  eye,  etc.,  etc. 
Combined  with  carbolic  acid,  it  forms  a  very  useful  ointment 
for  affections  of  the  skin,  etc.,  etc. 

Dental  Uses.  Vaseline  is  an  efficacious  application  to  in- 
flamed and  excoriated  surfaces  of  the  gums  and  mucous  mem- 


VERATRINA VERATRINE.  281 

brane  of  the  mouth  ;  also  as  a  dressing  introduced  into  the 
canals  of  teeth  affected  with  periostitis,  and  as  an  emollient 
application  after  the  devitalization  and  removal  of  dental 
pulps. 

In  the  form  of  Vaseline  CanipJior  Ice,  it  is  a  pleasant  and 
efficacious  application  to  chapped  lips  and  hands,  being  bland 
and  non-irritating  in  its  action. 

An  ointment  made  by  dissolving  and  incorporating  thor- 
oughly by  the  aid  of  heat,  equal  parts  of  vaseline  and  lead 
plaster,  to  which  a  little  bergamot  may  be  added  for  perfume, 
is  very  serviceable  for  the  treatment  of  excoriated  surfaces, 
and  dry  desquamating  surfaces  of  certain  skin  diseases,  and 
especially  to  the  form  of  skin  affection  which  may  result  from 
the  constant  use  of  scented  soaps  on  the  hands. 

VERATRINA— VERATRINE. 

Source.  Veratrine  is  an  alkaloid,  or  a  mixture  of  alkaloids 
obtained  from  the  seeds  of  asagrcsa  officinalis,  of  the  natural 
order  MelanthacecB.  It  is  in  the  form  of  a  white,  or  grayish- 
white  amorphous  powder,  of  an  acrid  taste,  imparting  a  sensa- 
tion of  tingling  and  numbness  to  the  tongue,  and  causing  con- 
striction of  the  fauces  and  violent  sneezing.  It  is  but  slightly 
soluble  in  cold  or  hot  water,  to  which  it  imparts  an  acrid  taste 
and  a  somewhat  alkaline  reaction. 

It  is  soluble  in  three  parts  of  alcohol  at  59°  F.,  and  very 
soluble  in  boiling  alcohol ;  also  soluble  in  6  parts  of  ether,  in  2 
parts  of  chloroform,  and  in  96  parts  of  glycerin  ;  it  melts  when 
heated. 

Veratrine  Ointment — Unguentnm  Veratrincs — is  composed 
of  veratrine,  4  parts  ;  alcohol,  6  parts  ;  benzoinated  lard,  96 
parts.  The  veratrine  is  rubbed  with  the  alcohol  in  a  warm 
mortar  until  dissolved,  and  the  benzoinated  lard  gradually 
added  and  thoroughly  mixed. 

Therapeutic  Uses.  Veratrine  is  used  only  externally  in  neu- 
ralgia, myalgia,  headache,  rheumatism,  paralysis,  etc.,  in  the 
form  of  the  ointment,  or  dissolved  in  alcohol. 

19 


282  DENTAL    MEDICINE. 


Dental  Use.  Veratrine,  in  the  form  of  the  ointment,  is  used 
for  facial  and  other  forms  of  neuralgia,  a  small  quantity  being 
rubbed  over  the  seat  of  pain. 

VERATRUM  VIRIDE— AMERICAN    HELLEBORE. 
(Poke  Root.) 

Source.  Veratrum  viride,  of  the  natural  order  Melaiithacece, 
the  officinal  portion  of  which  is  the  root,  is  indigenous  to  the 
swampy  portions  of  the  United  States,  and  is  prepared  in  the 
form  of  slices  or  fragments,  of  a  dark  or  blackish-gray  color 
externally,  and  of  a  grayish-white  color  internally.  Its  odor 
is  peculiar,  especially  when  it  is  moistened,  and  its  taste  is 
bitter  and  acrid.  It  is  inodorous,  but  in  the  form  of  powder 
is  sternutatory.  It  is  similar  in  chemical  composition  to  vera- 
trum album — white  hellebore,  and  veratrum  sabadillae.  Like 
veratrum  album,  it  contains  a  quantity  of  soft  resin,  and  two 
alkaloids — -jervia  and  veratj^oidia. 

Medical  Properties  and  Action.  Veratrum  viride  is  acrid  and 
sedative,  causing  redness  and  heat  when  applied  to  the  skin, 
and  has  a  violent  sternutatory  effect  on  the  Schneiderian  mem- 
brane. Small  doses  stimulate  the  secretions  and  depress  the 
pulse.  Although  a  prompt  emetic,  its  operation  is  attended 
with  intense  nausea  and  depression,  and  violent,  persistent 
vomiting.  Large  doses  occasion  great  depression,  with  a  weak 
action  of  the  heart  and  pulse,  vomiting,  retching,  cold  surface 
of  body,  a  cold  perspiration,  faintness,  dimness  of  sight,  dilata- 
tion of  the  pupils,  great  muscular  weakness,  slow  respiration, 
and  sometimes  coma,  insensibility  and  stertorous  breathing, 
but  notwithstanding  such  symptoms,  fatal  results  are  rare. 
The  antidotes  are  free  stimulants.  The  tincture — Tinctiira 
Veratri  Viridis,  is  the  best  preparation  for  internal  adminis- 
tration. 

Therapeutic  Uses.  Veratrum  viride  is  not  employed  for  its 
emetic  effect,  on  account  of  its  violent  action.  Internally  it  is 
administered  in  diseases  of  the  heart,  active  hemorrhage  in 
the  plethoric,  to  reduce  the  temperature  and  pulse  in  "  typhoid 


XANTHOXYLUM — PRICKLY    ASH,  283 

and  other  fevers,"  in  acute  mania  and  delirium,  in  puerperal 
convulsions,  neuralgia,  neuralgic  headache,  etc.,  etc.  Exter- 
nally it  is  employed  for  neuralgia,  myalgia,  headache,  rheuma- 
tism, paralysis,  etc.,  etc. 

Dose.  Of  the  Tincture  of  Veratrum  Viride,  Tt\,ij  to  tt\^v,  of 
the  Fluid  Extract  of  Veratrum  Viride — Extractiini  Veratri 
Viridis  Fhtidnni,  wj]  to  ttv,v. 

Dental  Uses.     In  dental   practice  the  tincture  of  veratrum 

viride  has  been  employed  internally  for  neuralgia  of  the  fifth 

nerve  ;  also  in  dental  periostitis,  as  a  sedative  ;  also  in  severe 

hemorrhage    from    the    extraction    of   teeth,    to    depress    the 

heart's  action. 

DENTAL  FORMULA. 

For  Facial  Neuralgia. 
Da  Costa. 

U.     Veratrise gr.  xv 

Aconitiae gr.  ij 

Glycerinse f^ij 

Cerati  adipis f^vj.         M. 

SiGNA. — To  be  rubbed  over  painful  part, 
care  being  taken  to  see  that  there  is 
no  abrasion  of  the  skin. 

XANTHOXYLUM— PRICKLY  ASH. 

Source.  Xanthoxylum  is  a  shrub  growing  in  the  Northern, 
Middle  and  Western  States  of  North  America.  The  bark  is 
the  officinal  portion,  and  is  obtained  in  the  form  of  pieces, 
more  or  less  quilled,  of  one  or  two  lines  in  thickness  and  of 
a  whitish  color,  with  an  ash-colored  epidermis.  It  is  quite 
inodorous  and  has  a  taste  at  first  sweetish  and  slightly  aro- 
matic and  afterwards  bitter  and  acrid. 

Medical  Properties  and  Action.  Xanthoxylum  is  aromatic, 
stimulant,  and  sialagogue,  and  when  swallowed  occasions  a 
sense  of  heat  in  the  stomach,  more  or  less  general  arterial 
excitement,  and  a  tendency  to  diaphoresis. 

Tlierape2itic  Uses.  Xanthoxylum  has  been  administered 
with  considerable  benefit  in  the  chronic  form  of  rheumatism. 

Dose.  Of  Powdered  Xanthoxylum,  gr.  x  to  5ss,  three  or 
four  times  a  day. 


284  DENTAL    MEDICINE. 


Dental  Uses.  Xanthoxylum,  in  the  form  of  the  powder,  has 
been  apphed  with  success  to  an  aching  pulp  for  the  rehef 
of  odontalgia,  and  a  decoction  of  the  bark  is  employed  as  a 
wash  for  foul  ulcers ;  in  the  form  of  a  tincture  it  is  efficacious 
in  relieving  the  soreness  which  remains  after  the  extirpation 
of  the  dental  pulp ;  it  is  applied  on  floss  silk  or  cotton.  In 
the  Southern  States  the  Angelica  Tree — Aralia  Spinosa,  some- 
times called  '  Toothache  Tree,'  is  often  called  prickly-ash,  but 
it  differs  from  Xanthoxylum,  although  its  tincture  answers  for 
the  relief  of  odontalgia. 

ZINCI    CHLORIDUM— CHLORIDE   OF   ZINC. 

For7n2ila.     ZnClj. 

Derivation.  Chloride  of  zinc  is  obtained  by  the  action  of 
hydrochloric  acid  on  granulated  zinc,  the  solution  thus  made 
being  purified  by  a  solution  of  chlorine  and  carbonate  of  zinc, 
when  it  is  evaporated  till  it  assumes  a  solid  form.  It  is  in 
the  form  of  a  white  deliquescent  salt,  freely  soluble  in  water, 
alcohol  and  ether,  as  soft  as  wax,  and  capable  of  being  melted 
and  sublimed  by  heat  As  it  rapidly  deliquesces  when  exposed 
to  the  air,  it  should  be  kept  in  glass-stoppered  bottles.  It  has 
a  styptic,  metallic  taste,  which  is  very  disagreeable. 

Medical  Properties  and  Action.  Chloride  of  zinc  is  the  most 
active  of  the  zinc  preparations,  being  a  powerful  and  pene- 
trating escharotic.  Its  local  action  as  a  caustic  depends  upon 
its  affinity  for  albumen  and  gelatin,  and  when  in  contact  with 
living  parts  it  destroys  their  vitality,  and  uniting  with  the 
albuminous  and  gelatinous  matters  present,  forms  an  eschar. 
It  is  also  a  useful  deodorizer  and  disinfectant,  and  largely 
diluted  has  been  employed  as  a  nervine  tonic ;  but  as  the 
milder  preparations  of  zinc  answer  the  same  purpose,  it  is 
rarely  employed  internally.  On  account  of  the  great  affinity 
for  water  and  its  power  of  combination  with  albumen,  chloride 
of  zinc  penetrates  and  spreads  deeply,  and  produces  an  eschar 
which  is  white,  thick  and  hard.  When  applied  to  malignant 
and  indolent  ulcers,  it  promotes  healthy  granulations,  and  when 
topically  applied  it  not  only  destroys  the  diseased  structure, 


ZINCI    CHLORIDUM — CHLORIDE    OF    ZINC.  285 

but  excites  a  new  and  healthy  action  in  the  surrounding  parts. 
When  employed  as  a  caustic,  it  does  not  give  rise  to  con- 
stitutional disorder  from  absorption,  an  effect  which  is  some- 
times caused  by  arsenical  preparations.  In  over  doses  it  causes 
a  burning  pain  in  the  throat  and  stomach,  nausea,  vomiting, 
cold  sweats,  decrease  of  pulse,  cramps  of  the  limbs,  etc.,  being 
a  powerful  irritant  poison.  The  antidotes  in  poisoning  by 
zinc  salts  are  albumen,  carbonate  of  soda,  magnesia  and 
soap. 

Therapeutic  Uses.  Chloride  of  zinc  has  been  employed  in- 
ternally in  chorea,  epilepsy,  neuralgia,  scrofula,  and  combined 
with  hydrocyanic  acid  in  facial  neuralgia.  Externally  it  is 
applied  to  malignant  growths,  gonorrhoea,  indolent  ulcers,  etc. 
A  solution  of  the  chloride  of  zinc  is  used  as  an  antiseptic  and 
disinfectant. 

Liquor  Zinci  Chloridi — Solution  of  Chloride  of  Zinc, 
known  as  "  Burnett's  Disinfecting  Fluid,"  is  composed  of 
Chloride  of  Zinc,  gr.  cc,  water,  Sj- 

Dose.  Of  Chloride  of  Zinc,  gr.  ss,  or  gr.  j,  or  gr.  ij,  largely 
diluted. 

Dental  Uses.  Chloride  of  zinc  is  a  valuable  agent  in  dental 
practice,  being  employed  as  an  external  application  to  sensitive 
dentine.  As  an  obtunding  agent  a  drop  of  the  deliquescent 
chloride  is  placed  in  contact  with  the  sensitive  dentinal  surface 
(which  has  previously  been  dried  and  is  protected  from  all 
moisture),  and  allowed  to  remain  for  from  two  to  four  minutes. 
Considerable  pain  follows  the  application  of  the  chloride,  which 
is  of  a  steady,  continuous  character,  without  the  throbbing 
nature  which  characterizes  the  pain  of  an  irritated  dental  pulp. 
Its  painful  action  may  be  modified  by  bathing  the  sensitive 
surface,  prior  to  the  application  of  the  chloride,  with  chloro- 
form, tincture  of  aconite  or  atropine  solution,  or  a  combination 
made.  When  the  pain  has  subsided  the  excavation  of  the 
cavity  can  be  proceeded  with  until  the  layer  of  dentine  affected 
by  the  chloride  has  been  removed,  when  another  application 
may  be  necessary.  As  it  is  not  absorbed  by  the  dentine  to 
any   great   degree,   its    action  being  superficial,   it   is    not  so 


286  DENTAL    MEDICINE. 


dangerous  an  agent  as  is  arsenious  acid  when  employed  for 
the  same  purpose. 

In  no  case  should  the  chloride  of  zinc  be  used  as  an 
obtunding  agent,  when  there  is  danger  of  irritating  the  pulp 
of  the  tooth. 

Applied  to  dentine  its  superficial  action  is  owing  to  its  soon 
becoming  decomposed.  Chloride  of  zinc  is  also  employed  to 
arrest  superficial  hemorrhage  from  a  wound  of  the  gum  during 
the  filling  of  teeth;  it  will  also  temporarily  arrest  the  secretion 
of  mucus  from  the  surface  of  the  mucous  membrane  of  the 
mouth.  When  applied  to  a  cut  surface  it  induces  union  by 
first  intention,  by  its  effect  upon  the  glutinous  matter. 

It  has  also  been  successfully  employed  as  an  injection  for 
chronic  alveolar  abscesses,  and  in  the  treatment  of  ulceration 
of  the  gums  attended  with  recession  of  gum  and  absorption  of 
process  from  the  necks  of  teeth ;  also  as  an  injection  in  disease 
of  the  antrum.  It  has  been  claimed  that  its  application  in 
a  diluted  form  will  promote  the  formation  of  secondary  den- 
tine over  a  nearly  exposed  pulp,  but  its  escharotic  action  must 
be  considered  in  using  the  agent  for  such  a  purpose.  When 
applied  to  the  sulcus  which  often  forms  during  ulceration  and 
recession  of  the  gum  from  the  neck  of  a  tooth,  the  application 
can  be  safely  and  conveniently  made  by  means  of  a  camel's- 
hair  brush,  or  by  a  piece  of  orange  wood  so  shaped  as  to 
permit  of  its  being  introduced  to  the  bottom  of  such  a  sulcus. 
Chloride  of  zinc  in  a  properly  diluted  form  is  an  efficient 
disinfectant,  and  has  been  employed  for  such  a  purpose  in 
gangrenous  conditions  of  the  mouth. 

Chloride  of  zinc  is  one  of  the  ingredients  of  the  temporary 
filling  material  composed  of  the  chloride  of  zinc  in  solution 
and  the  oxide  of  zinc,  which  has  been  employed  to  cap  the 
exposed  pulps  of  teeth.  But  owing  to  the  escharotic  action 
of  the  chloride  this  method  has  not  been  uniformly  successful. 
The  zinc  preparations,  however,  answer  good  purposes  as  tem- 
porary filling  materials,  especially  in  sensitive  cavities  where 
the  presence  of  metallic  fillings  would  not  be  tolerated.  (See 
Appendix  to  Dental  Formulary.) 


ZINCI    SULPHAS SULPHATE    OF    ZINC.  287 

ZINCI  OXIDUM— OXIDE  OF  ZINC. 

Formula,  ZnO. 

Derivation.  Oxide  of  zinc  is  obtained  by  subjecting  precipi- 
tated carbonate  of  zinc  to  a  red  heat,  till  the  whole  of  the 
carbonic  acid  and  water  are  expelled. 

It  is  in  the  form  of  a  yellowish-white  powder,  insoluble  in 
water,  but  soluble  in  dilute  sulphuric  and  hydrochloric  acids, 
without  effervescence.     It  is  inodorous  and  tasteless. 

Medical  Properties  and  Action.  Oxide  of  zinc  is  tonic  and 
antispasmodic,  but  in  large  doses  causes  vomiting  and  purg- 
ing ;  by  gradually  increasing  the  dose,  large  quantities  can  be 
taken  without  injurious  effects.  It  should  never  be  given  on 
an  empty  stomach,  as  it  may  cause  nausea. 

Therapeutic  Uses.  It  is  employed  in  spasmodic  asthma,  con- 
vulsions of  children,  epilepsy,  chorea,  hooping  cough,  hys- 
teria, and  is  an  excellent  remedy  for  gastralgia ;  also  in  chronic 
diarrhoea  and  chronic  dysentery. 

Dose.     Of  Oxide  of  Zinc,  gr.  ss  to  gr.  x. 

Dental  Uses.  Oxide  of  zinc  may  be  employed  in  the  treat- 
ment of  convulsions  of  children  during  dentition,  given  in 
doses  of  gr.  ss  to  gr.  v,  gradually  increased  to  gr.  viij,  in  pow- 
der, with  a  little  sugar.  It  is  also  combined  with  carbolic  acid, 
in  a  fluid  form,  for  capping  exposed  pulps,  being  applied  in  the 
form  of  a  paste  to  the  exposed  surface  of  the  dental  pulp.  It 
also  forms  an  ingredient  of  the  zinc-filling  materials,  and  of 
the  celluloid  base  for  artificial  teeth.  (See  Appendix  to 
Dental  Formulary.) 

ZINCI  SULPHAS— SULPHATE  OF  ZINC. 

Formula.     ZnS04  /HgO. 

Derivation.  Sulphate  of  zinc  is  obtained  by  the  action  of 
sulphuric  acid  on  granulated  zinc,  the  solution  being  purified 
by  means  of  chlorine  and  carbonate  of  zinc,  and  afterwards 
evaporated,  the  product  being  crystals  of  sulphate  of  zinc.  It 
is  in  the  form  of  colorless  crystals,  which  effloresce  on  expos- 
ure to  air,  and  are  soluble  in  water  and  insoluble  in  alcohol, 


288  DENTAL    MEDICINE. 


resembling  in  appearance  Epsom  salts.  It  has  a  disagreeable, 
metallic,  styptic  taste. 

Medical  Properties  and  Action.  Sulphate  of  zinc  is  tonic, 
astringent,  antispasmodic,  and,  in  large  doses,  emetic.  Exter- 
nally, it  is  stimulant  and  astringent.  When  its  use  is  long  con- 
tinued, it  produces  symptoms  like  those  of  lead.  When 
administered  in  proper  doses,  it  exerts  an  antispasmodic  in- 
fluence on  the  nervous  system,  and  where  there  is  spasm  and 
convulsion,  it  is  very  serviceable. 

TJierapeutic  Uses.  It  is  internally  administered  in  epilepsy, 
chorea,  hysteria,  angina  pectoris,  chronic  dysentery,  flatulence, 
night  sweats  of  phthisis,  etc.,  and  is  a  prompt  emetic  in  cases 
of  narcotic  poisoning.  Externally,  it  is  employed  in  the  treat- 
ment of  gonorrhoea,  diseases  of  the  eye,  chronic  skin  diseases, 
epithelioma,  ulcers,  gangrene,  etc. 

Dose.  Of  Sulphate  of  Zinc,  gr.  \  to  gr.  vj.  For  an  emetic 
in  cases  of  poisoning  six  grains  will  prove  sufficient,  well 
diluted  with  water,  and  repeated  every  fifteen  minutes  until 
emesis  occurs. 

Dental  Uses.  Sulphate  of  zinc  is  employed  externally  in 
dental  practice,  in  gangrene  of  the  mouth,  disease  of  the 
antrum,  ulcerations  of  mucous  membrane,  and  indolent 
ulcers,  acting  as  a  stimulant  and  astringent. 

DENTAL  FORMULA. 

For  Gangi-ene  of  the  Month,  [Cana-tim  For   Ulceration  of  Mucous  Membrane 

Oris).  of  the  Month. 

R.     Zinci  Sulphat gr.  xx  R.     Zinci  Sulphat gr.  j  to  v 

Mellis 5J.       M.  Aqua8  Destillat3e....gj.               M. 

SiGNA. — To  be  applied  with  a  camel's  SiGNA. — To   be   used   as   a   gargle    or 

hair  brush.  lotion. 

For  Chronic  Alveolar  Abscesses,  Abscess 

of  Antrtini,  etc. 

G.  L.  Parmele. 

R.     Zinci  Sulphat g""- iij 

Plumbi  Acetatis gr.  v 

Tinct.  Catechu, gtt.  x 

Aquas fgj.  M. 

SiGNA. — Use  as  a  stimulating  injection. 


TOPICAL    REMEDIES.  289 

TOPICAL   REMEDIES. 

Medicinal  substances  are  applied  to  the  mucous  membrane 
of  the  mouth,  and  to  the  dental  structures,  almost  exclusively 
for  local  effects.  In  dental  practice  antiseptic  remedies  are 
extensively  employed  to  arrest  fermentative  and  putrefactive 
processes,  as  every  kind  of  fermentation  depends  upon  the 
growth  and  increase  of  a  living  organism.  Various  diseases 
of  the  dental  structures  have  a  close  relationship  with  low 
organisms,  in  the  morbid  processes  which  result  during  their 
progress,  and  which  are  maintained  and  developed  by  the 
presence  of  living  matter.  The  remedies  recognized  as  be- 
longing to  the  group  of  antiseptics,  when  brought  into  con- 
tact with  the  disease  germs,  which  are  constituted  of  these 
organized  forms  of  life,  have  the  power  of  destroying  their 
vitality  and  of  arresting  the  fermentative  or  putrefactive  pro- 
cess which  they  either  develop  or  promote.  The  effect  of 
escharotics  when  applied  to  a  part  of  which  the  structure  and 
vitality  are  to  be  destroyed,  is  to  produce  an  eschar,  and  incite 
inflammation  and  suppuration  of  the  adjacent  tissues,  by  which 
the  slough  is  separated  from  the  living  parts. 

Medicinal  substances  are  applied  to  the  mucous  membrane 
of  the  mouth  in  the  form  of  gargles  or  mouth  washes,  lotions 
and  injections,  and  generally  for  a  local  effect. 

Medicinal  substances  are  applied  to  the  skin  for  both  a  local 
and  general  effect,  either  by  friction,  by  the  endermic,  or  by 
the  hypodermic  methods.  In  the  endermic  nietJiod  the  cuticle 
is  usually  removed  by  the  action  of  a  blister  and  the  medicinal 
agent  is  applied  to  the  denuded  surface  in  the  form  of  a  powder 
or  ointment,  and  is  a  useful  method  when  the  irritability  of  the 
stomach  or  difficult  deglutition  prevents  medicines  from  being 
taken  through  the  mouth. 

The  hypodermic  method  consists  in  injecting  medicines  by 
means  of  a  graduated  syringe  with  a  sharp-pointed  nozzle,  and 
constructed  for  the  purpose,  into  the  subcutaneous  cellular 
tissue,  thus  producing  both  a  local  and  general  effect,  and  an 
impression  is  made  much  more  rapidly  than  when  the  medicine 


290  DENTAL    MEDICINE. 


is  taken  into  the  stomach.  The  medicinal  agents  used  for  hypo- 
dermic injections  are  so  prepared  as  to  be  perfectly  soluble,  and 
of  considerable  strength  in  small  bulk.  Anodynes  thus  used 
are  more  rapid  in  their  effect,  and  the  general  rule  as  regards 
the  quantity  is,  that  in  first  injections  the  dose  should  be,  for 
males,  two-thirds  of  the  ordinary  dose  by  the  stomach,  and 
for  females,  about  one-half  It  is  very  necessary  that  a  vein 
should  not  be  punctured  when  introducing  the  point  of  the 
syringe.  The  insertion  of  the  deltoid  muscle  in  the  arm  is 
generally  selected  as  the  place  for  injection,  and  the  needle- 
point of  the  syringe  should  not  be  inserted  very  deep,  nor  at 
the  same  point  in  subsequent  injections. 

Medicinal  substances  of  the  classes  of  rubefacients  and 
epispastics  are  employed  as  coimter-in'itants,  their  effect  being 
to  establish  external  or  artificial  irritation  for  the  relief  or  cure 
of  internal  inflammation  existing  in  a  part  or  in  the  body. 
The  extent  and  character  of  the  counter-irritation  thus  es- 
tablished should  be  in  a  great  measure  regulated  by  the 
character  of  the  disease  which  it  is  intended  to  relieve ;  a 
rubefacient  being  indicated  in  irritation  of  mucous  membrane, 
a  seton  or  issue  when  the  disease  is  of  a  suppurative  character, 
and  a  vesicant  in  inflammation  of  serous  membranes. 

Setons  and  Issues  are  employed  to  produce  permanent 
counter-irritant  effects.  A  seton  consists  of  a  skein  of  silk  or 
a  piece  of  tape  or  other  substance  passed  through  the  in- 
tegument by  means  of  a  seton-needle,  and  allowed  to  remain 
so  that  a  discharge  is  maintained.  A  simple  seton  in  the 
case  of  an  incision  into  an  alveolar  abscess,  is  composed  of  a 
single  or  double  strand  of  floss  silk  introduced  into  a  wound 
made  by  the  lancet,  or  into  the  orifice  of  a  fistulous  opening, 
after  the  pus  of  the  abscess  has  been  evacuated,  to  maintain  a 
free  exit  for  the  pus  which  may  be  secreted  after  the  first 
operation;  fine  silver  wire  is  also  employed  for  the  same 
purpose.  An  issue  is  generally  some  irritating  substance, 
such  as  caustic  potassa,  or  a  small  pea,  or  piece  of  orris  root, 
introduced  to  maintain  a  discharge. 

Bloodletting  is  performed  for  the  purpose  of  lessening  vascu- 


TOPICAL    REMEDIES.  291 


lar  excitement,  reducing  inflammatory  action,  relieving  con- 
gestive pain  and  spasm,  promoting  absorption,  relaxing  the 
muscles  and  arresting  hemorrhage.  It  is  divided  into  general 
and  local,  general  bloodletting  consisting  of  venesection  or 
phlebotomy,  the  median  cephalic  or  basilic  veins  of  the  arm, 
and  occasionally  the  external  jugular  and  other  veins,  being 
the  ones  selected  from  which  to  draw  the  blood.  But  it 
should  be  resorted  to  with  caution,  as  it  is  a  powerful  and 
exhausting  agent. 

Local  Bloodletting  is  chiefly  employed  for  the  relief  of  local 
inflammations  and  congestions,  and  is  accomplished  by  means 
of  leeches,  cups,  and  scarifications. 

The  leech — Jiirudo — is  commonly  employed  as  an  agent  for 
local  bloodletting,  and  is  preferable  to  "  cupping  "  in  many  loc^l 
and  chronic  forms  of  inflammation  ;  also  in  infantile  affections 
which  require  such  an  operation,  when  the  American  leech  is 
used,  as  it  makes  a  smaller  incision  than  the  European  leech, 
and  draws  less  blood.  A  leech  is  supposed  to  draw,  on  an 
average,  about  a  drachm  and  a  half  to  two  drachms  of  blood 
before  it  is  removed,  and  the  quantity  which  subsequently 
flows  will  generally  equal  that  drawn  by  the  leech. 

Leeches  are  often  applied  to  the  gum  over  the  root  of  a 
tooth  affected  with  acute  periostitis,  to  relieve  the  inflammation 
and  congestion.  To  make  the  leech  bite  readily,  the  surface 
to  which  it  is  to  be  applied  may  be  smeared  with  cream  or 
sweet  milk,  or  a  puncture  may  be  made  in  it,  so  as  to  draw 
blood,  and,  to  isolate  the  part  of  the  surface  on  which  it  is 
desired  to  apply  the  leech,  a  small  hole  may  be  made  in  a  piece 
of  bibulous  paper,  which  will  adhere  to  a  dry  surface  of  the 
gum,  and  aflbrd  an  opening  for  the  mouth  of  the  leech  to  ap- 
proach the  surface. 

To  remove  a  leech,  if  it  does  not  drop  off  of  its  own  accord, 
which  they  will  generally  do  in  from  fifteen  to  twenty  minutes, 
it  may  be  sprinkled  with  a  little  cold  water  or  diluted  vinegar, 
or  powdered  sugar.  To  promote  bleeding  from  leech  bites, 
fomentations  or  warm  dry  cloths,  or  a  cupping  glass,  may  be 
used.     To  check  the  hemorrhage   from   leech   bites,  which   is 


292  DENTAL    MEDICINE. 


sometimes  excessive,  firm  pressure  may  be  made  with  the  fin- 
ger, or  exposure  to  cold  air,  or  the  apphcation  of  such  styptics 
as  alum  or  matico. 

Clipping  is  employed  when  it  is  desired  to  draw  blood  rap- 
idly, or  to  ascertain  the  exact  quantity  of  blood  drawn,  or  when 
it  is  desirable  to  make  an  impression  on  the  system.  Cupping 
is  performed  by  means  of  cupping  glasses  and  a  scarificator. 
The  glasses  are  applied  after  being  partially  exhausted  of  air, 
when  the  removal  of  the  atmospheric  pressure  produces  a  de- 
termination of  blood  to  the  capillaries  of  the  part,  and  it  is 
afterwards  easily  drawn  by  scarification. 

Scarifications  consist  of  small  incisions  made  in  inflamed 
and  congested  parts,  to  relieve  the  engorged  condition  of  the 
capillary  vessels,  and  are  sometimes  employed  to  relieve,  acute 
inflammation  of  the  gums  and  mucous  membrane  of  the 
mouth. 

ERUPTION  OF  THE  TEETH. 

TEMPORARY   TEETH. 

(The  inferior  generally  precede  the  superior  by  two  or  three 
months.) 

Central   incisors,  ,         .         .          5  to    8  months. 

Lateral         "  .         .         .             7  to  10        " 

1st  molars,          .  .         .         .        12  to  16        " 

Canines,         .  .          .         .             15  to  20        " 

2d  molars,           .  .         .         .       20  to  36        " 

PERMANENT    TEETH. 

1st  molars,  .         .         ,         .           5  to    6  years. 

Central  incisors,        .  .         .          .      6  to    8 

Lateral      "  .         .         .         .           7  to    9 

1st  bicuspids,  .         .          .         .         .      9  to  10 

2d           "  .         .         .         .          10  to  II 

Canines,  .         .         .         .         .    11  to  12 

2d  molars,  .         .         .         .         j  2  to  14 

3d         " 17  to  21 


THERAPEUTICS    OF    ELECTRICITY.  293 

ELECTRICITY   AS    A    THERAPEUTIC    MEANS    IN 
THE  TREATMENT  OF  DISEASE. 

Electricity  is  a  powerful  agent  in  many  forms  of  nervous 
disease,  especially  in  the  treatment  of  paralysis  and  neuralgia. 

Three  forms  of  electricity  are  employed,  viz. :  The  induced 
current,  \}i\&  galvanic  current,  both  of  which  are  dynamical,  and 
the  static  current,  which  is  frictional. 

Galvanic  electricity — galvanism,  and  induced  electricity — 
Faradism,  are  the  two  forms  generally  employed,  frictional 
electricity  being  but  seldom  applied.  What  is  known  as  electro- 
magnetism  is  a  form  of  induced  current,  generated  by  the 
rotary  instrument,  and  is  not  reliable.  Faradism,  so  called 
from  its  discoverer,  is  generated  by  an  instrument  which  is 
capable  of  applying  slow  or  rapid  shocks,  and  giving  what  is 
denominated  a  fine,  strong  induced  current.  It  consists  of 
coils  of  wire  ;  a  ^mall  hammer  of  soft  iron,  attached  to  a 
spring;  a  pole,  containing  a  platinum-pointed  screw  ;  the  ham- 
mer breaking  the  current  in  the  coil  of  wire,  and  by  rapid 
vibration  producing  shocks. 

"  The  galvanic  current  is  generated  by  a  series  of  cells,  suffi- 
cient in  number  to  cause  a  current  of  tension,  which  is  the 
resistance  offered  to  the  passage  of  a  current. 

"  One  cell  supplies  a  current,  the  poles  of  other  cells  being 
alternately  joined,  and  there  are  finally  but  two  terminal  poles." 
As  the  current  from  the  first  cell  passes  through  the  remaining 
cells,  its  power  is  increased  and  the  effect  is  governed  by  the 
number  of  cells  belonging  to  the  circuit.  There  is  also  what 
is  denominated  a  current  of  "  quantity,"  which  is  generated  by 
a  large  metallic  surface  in  the  battery  cell,  the  tension  current 
being  generated  by  a  number  of  small  metal  plates.  The 
"  tension  current "  serves  the  best  purpose  for  medical  use, 
while  the  "  quantity  current "  furnishes  heat,  and  is,  therefore, 
adapted  to  purposes  of  electro-surgery.  The  modified  Bunsen 
galvanic  cell,  is  the  best  for  medical  purposes,  although  what 
is  known  as  the  Siemens  and  Halske  cell  is  extensively  used ; 
"  it  consists  of  an  outer  cell  of  glass,  with   elements   of  zinc 


294  DENTAL   MEDICINE. 


and  copper,  a  diaphragm  of  porous  earthenware,  and  a  dia- 
phragm of  papier  mache,  between  the  solutions."  The  Holtz 
electric  instrument  furnishes  the  best  static  current. 

The  Ruhmkorff  coil  is  also  employed,  in  the  use  of  which 
but  one  wire  is  brought  in  contact  with  the  patient,  the  other 
conductor  being  formed  by  the  air,  and  a  spark,  similar  to  the 
ordinary  spark  from  the  friction  machine,  being  produced. 

When  electricity  is  applied  to  the  body,  sponges  of  differ- 
ent sizes,  or  polished  metallic  surfaces,  known  as  "  electrodes," 
the  metallic  being  the  best,  are  employed,  the  effect  upon  the 
skin  being  similar  to  what  is  caused  by  puncturing  with  many 
small  needles.  The  theory  of  electro-therapeutics  is  dependent 
upon  the  following  effects  : — 

"  If  a  portion  of  a  motor  nerve  is  included  between  the  poles 
of  a  galvanic  battery,  it  is  said  to  be  polarized,  and  in  a  state 
of  electrotonus.  At  the  positive  pole,  the  irritability  of  the 
nerve  is  diminished,  while  at  the  negative  it  is  excited  and 
more  susceptible  to  stimulation.  The  condition  at  the  positive 
pole  is  called  aiielectrotomis,  and  that  at  the  negative  catelcctro- 
tonus.  The  positive  pole  is  known  as  the  anode  ;  the  negative, 
the  cathode,  and  these  give  the  name  to  the  states  described. 
A  nerve  is  said  to  be  tetanized  when  the  muscle  supplied  is 
thrown  into  a  state  of  permanent  tetanic  contraction  by  a  rap- 
idly intermitting  current.  The  passage  of  a  number  of  these 
shocks  for  some  time  will  diminish  the  irritability  of  the  nerve 
to  such  an  extent,  that,  finally,  there  will  be  no  further  response. 
An  ascending  current  causes  a  greater  irritability  in  a  nerve 
than  a  descending  one  ;  a  descending  one  depresses  excitability. 
The  stimulus  is  felt  at  the  negative  pole  when  the  current  com- 
mences, and,  when  it  is  broken,  it  is  felt  at  the  positive  pole. 
A  shock  is  felt  at  the  opening  of  the  weak  currents ;  with  mod- 
erately strong  ones,  it  is  felt  both  at  the  opening  and  the 
closure.  With  very  strong  currents,  it  is  impossible  to  tell  the 
points  of  sensation,  as  the  power  of  the  nerve  is  impaired." 
The  action  upon  involuntary  is  less  than  upon  the  voluntary, 
and,  as  regards  the  latter,  it  is  the  same,  or  nearly  so,  as  long 
as  the  integrity  of  their  immediate  nerve  supply  is  concerned. 


THERAPEUTICS    OF    ELECTRICITY.  295 

Degenerations  and  atrophies  of  muscles  interfere  to  a  consid- 
erable extent  with  their  susceptibility  to  electric  currents ; 
hence  it  is  better,  in  diseased  conditions,  to  pass  the  current 
through  the  nerve  trunk  which  supplies  them.  The  Faradic 
current  has  but  a  local  effect,  the  deeper  muscles  and  nerves 
escaping. 

When  a  metallic  or  sponge  electrode  is  applied  to  the 
moistened  skin,  a  prickling  sensation  follows,  attended  with 
redness  and  tingling,  and  this  impression  on  the  cutaneous 
nerves  and  muscles  is  known  as  electro-niusciilar  sensibility. 
The  galvanic  current  occasions  a  sensation  of  warmth,  like 
that  produced  by  a  local  stimulant,  such  as  a  mustard  plaster, 
and  when  the  faradic  current  is  applied  to  the  dry  skin,  or 
when  the  electrodes  are  but  lightly  applied,  there  is  produced 
a  sensation  of  pain,  and  the  pain  is  the  greater  when  caused 
by  rapidly  succeeding  shocks  than  by  slow  ones. 

The  galvanic  current  causes  deeper  impressions  than  the 
faradic,  and  also  electrolytic  changes  different  from  the  faradic, 
producing  absorption  and  changing  the  structure  of  the  dif- 
ferent tissues,  and  beneficial  results  have  resulted  from  its 
application  in  diseases  of  the  brain.  The  physical  effects  of 
the  galvanic  current  upon  the  sympathetic  nerve  are  dilatation 
followed  by  contraction  of  the  pupil,  diminished  frequency  of 
the  pulse,  and  a  lowering  of  the  tension  of  the  carotid  arteries. 
When  electricity  is  used  for  the  purpose  of  diagnosis,  the 
existence  of  local  tenderness,  exalted  sensibility,  anaesthesia, 
paralysis,  diseases  of  the  brain,  spinal  cord,  etc.,  may  be  as- 
certained. It  has  also  been  used  to  determine  the  question  of 
doubtful  death,  whether  certain  affections  are  recent  or  of  long 
standing,  and  to  detect  malingering.  As  various  nervous  dis- 
eases are  associated  with  the  loss  of  such  functions  of  muscles 
as  contraction  and  sensation,  or  the  reverse,  electricity  deter- 
mines the  extent  of  such  changes. 

When  applying  the  electric  current,  the  anatomy  of  the 
part  affected  should  be  well  understood,  for  example,  for 
neuralgia  of  the  fifth  pair  of  nerves  one  pole  should  be 
applied  as  near  as  possible  to  the  point  of  exit  of  the  nerve 


296  DENTAL    MEDICINE. 


from  the  cranium,  and  the  other  pole  to  the  remote  parts  of 
distribution. 

Galvanism  and  Faradism  are  employed  for  the  relief  of 
pain  and  spasm,  to  improve  the  nutritive  processes,  and  to 
restore  deficient  muscular  power,  to  stimulate  sensation  in 
nerves,  to  stimulate  secretion,  to  influence  circulation,  to  cause 
absorption  of  fluids,  to  bring  about  the  absorption  of  morbid 
growths  and  deposits,  to  induce  sleep,  and  in  surgery,  in  the 
form  of  the  galvanic  cautery.  The  galvanic  current  is  con- 
sidered to  be  the  most  useful  for  the  mediate,  and  the  faradic 
current  for  the  immediate  application,  the  former  proving 
serviceable  in  all  forms  of  neuralgia,  and  especially  in  facial 
neuralgia,  and  the  latter  in  headaches,  especially  those  of  a 
rheumatic  nature. 

Galvanism  is  also  employed  with  advantage  in  sciatica, 
spinal  irritation  and  hysteria,  also  tumors  such  as  aneurisms 
and  goitre,  these  morbid  products  being  dispersed  by  con- 
necting the  two  poles  of  a  galvanic  battery  with  needles, 
which  are  thrust  into  the  morbid  growth  and  generate  a 
process  known  as  electrolysis.  In  such  operations  bubbles 
of  hydrogen  gas  are  disengaged  at  the  negative  pole,  which 
separate  mechanically  the  adjacent  tissues,  breaking  them  up 
in  such  a  manner  that  the  disintegrated  particles  may  be 
taken  up  by  the  circulation.  Oxygen  is  disengaged  at  the 
positive  pole,  which  forms  an  acid  with  certain  elements  of 
the  tissue,  and  the  albumen  is  coagulated,  forming  a  clot  if 
this  occurs  in  a  cavity  filled  with  blood. 

For  surgical  operations,  as  a  substitute  for  the  knife  or 
ecraseur,  a  platinum  wire  is  placed  between  the  poles  of  a 
powerful  battery,  the  wire  being  adjusted  in  a  handle,  which 
in  a  few  minutes  becomes  white  hot,  and  is  especially  ser- 
viceable for  operations  in  deep  cavities  where  it  would  be 
impossible  to  use  the  knife,  the  application  of  such  a  galvanic 
cautery  being  unattended  by  pain  or  hemorrhage. 

Strong  currents  of  electricity  should  not  be  applied  to 
the  head,  nor  its  use  be  persevered  in  for  more  than  fifteen 
minutes  at  a  time. 


APPENDIX    TO    DENTAL    FORMULARY. 


297 


Electro-magnetism  has  been  employed  for  relieving  pain 
during  the  extraction  of  teeth,  one  pole  of  an  ordinary  bat- 
tery being  attached  to  the  forceps  and  the  other  to  a  handle 
which  is  grasped  by  the  patient.  The  susceptibility  to  the 
current  is  first  ascertained  by  the  patient  holding  both  the 
forceps  and  the  handle  in  his  hands,  and  a  feeble  shock  ap- 
plied, which  is  gradually  increased  until  the  sensation  is  felt 
at  or  just  beyond  the  elbows,  when  the  current  is  somewhat 
reduced  in  power.  After  the  gum  has  been  lanced,  the  con- 
nection is  made  as  before  described,  by  the  patient  holding 
the  handle  and  the  operator  the  forceps  in  contact  with  the 
tooth  to  be  removed,  the  handles  of  the  instrument  being 
isolated,  when  the  operation  is  at  once  completed.  Great 
diversity  of  opinion,  however,  exists  as  to  the  efficiency  of 
this  method,  which  has  its  advocates  and  opponents. 


APPENDIX  TO  DENTAL  FORMULARY. 

Dentifrice  in  the  Form  of  Troches.  For  Ulceration  of  Gti??is  a?td  Ahicous 

R.     Cretse  Preparatae lb  iv  Meinbrane  of  Mouth. 

Sodii  Boratis  (Pulv.)...    §x  IJ.     Potassii  Chloras ^ij 

Saponis  Castil     "       ...   ^x  Aquee ^v.       M. 

Sacch.  Albffi        "       ...  R)  iss  Signa. — A  tablespoonful  3  times  a  day ; 

Ossis  Sepise         "      ...  Bb  \]^  also  as  a  gargle  4  or  5  times  a  day. 

Olei  Rosse gtt.  xxx  For  Neuralgia  of  the  Head. 

Millfleurs gj  voN  niemeyer. 

Essentise  Jasmin 5X"  K-     Ext.  Hyoscyami 

Mix  with  a  solution  of  Gum  Syrup.  Zinci  Oxidi aa ^  ij-       M. 

Antiseptic  Solution  for  Waslmig  and  SiGNA. — Fiat  pill.  xj. 

Spraying  Wounds,  etc.  Begin    with    one    pill    morning   and 

R.     Acidi  Carbolic!  (Cryst.)  partem  j  evening,  and   increase   to    xx   or   xxx 

Aquas part,  xxiv  daily, 

SiGNA. — Dilute  the  above  solution  with  For  Sensitiveness  Following  the  Re- 

equal  parts  of  water,  which  will  make  moval  of  Salivaiy  Calculus. 

it  equal  to  I  part  of  the  acid  to  40  coleman. 

parts  of  water ;  for  use  in  disinfecting  R.     Acidi  Tannici 55$ 

instruments  and  sponges.  Eau  de  Cologne f^iv-       M. 

For  a  Disinfectant  in  Mercurial  SiGNA. — Add   10  or  12   gtts.  of  above 

Salivatioti.  solution    to    a    teaspoonful    of   tepid 

R.     Potassii  Permanganat...  gr.  xv  water,  and  use  as  a  gargle  3  or  4  times 

Aquae i'^vn].  a  day. 

SiGNA. — Use  as  a  gargle. 
20 


298 


DENTAL   MEDICINE. 


For  Gangrene  of  Month  {^Cancrum 
Oris). 
R.     Bismuthi  Subnitratis  (Powd.) 

Applied  to  ulcerated  surface  and  cov- 
ered with  absorbent  cotton. 

For  internal  administration,  to  sup- 
port the  strength : — 

R  .     Quininas  Sulphat gr.  iij  to  v 

Tinct.  Ferri  Chloridi...  gtt.  v.  M. 
SiGNA. — Three  times  daily. 
For  Ptdpitis. 

GARRETSON. 

K.     Creasoti gtt.  vj 

Tinct.  lodinii '7^] 

Liq.  Plumb.  Subacet...    ^j 
Chloroformi 

Tinct.  Opii aa ,f  ss.    M. 

SiGNA. — Apply,  on  cotton,  to  exposed 
surface  of  pulp. 
For  Netwalgia  of  Superficial  Nerves. 

AITKEN. 

R.     Atropinse  Sulphat gr.  v 

Aquee  Destillat f.^iij-  M. 

SiGNA. — Use  on  a  compress  and  renew 
several  times  in  24  hours,  and  con- 
tinue for  at  least  one  hour  at  a  time, 
covering  with  oilskin,  to  prevent 
evaporation. 

For  Facial  Neuralgia. 

WALES. 

R.     Potassii  Bicarb 3;ss 

Ext.  Ergotse  fluidi f^j 

Infusi  Ergotse f^^j.     M. 

SiGNA. — Two  tablespoonfuls  every  4 
hours. 

For  Neuralgia.. 

R.     Zinci  Valerian ^ij 

Ext.  Gentianse ^j 

Ext.  Nucis  Vom gr.  v.  M. 

Fiat  pill,  No.  xx. 
SiGNA. — One  pill  three  or  four  times  a 
day. 


Oxychloride  of  Zinc  Preparaiion  for 
Filling  Teeth. 

POWDER. 

R.     Zinci  Oxidi gr.  xxx 

Sodii  Boratis gr.  ij 

Silicii  (Fine  Powd.) gr.  j. 

Mix  thoroughly  and  subject  to  a 
bright  red  heat  in  a  crucible.  Then 
grind  this  frit  to  a  powder,  and  mix  '^^ 
with  three  times  its  weight  of  Calcined 
Oxide  of  Zinc. 

LIQUID. 

R.     Zinci   Chloridi   (deliq.)  f^j 

Aquae f ^ vto vj. 

Oxyphosphate  of  Zinc  Preparation  for 
Filling  Teeth, 

POWDER. 

R.     Zinci  Oxidi partes  200 

Silicii  (Fine  Powd.)...  partes  viij 

Sodii  Boratis partes  iv 

Pulv.  Glass partes  v. 

Levigate  under  water,  to  ensure  com- 
plete admixture,  and  dry  by  evapora- 
tion ;  then  calcine  at  a  white  heat ;  then 
reduce  to  powder. 

LIQUID. 

R .     Acidi  Phosphorici 

Aquae q.  s.  to  dissolve. 

And  evaporate  the  solution  by  aid  of 
heat,  until  it  is  of  the  consistence  of 
glycerin. 

Another  Formula  for  the  Oxyphos- 
phate Preparation,  in  which  simply  the 
calcined  oxide  of  zinc  and  glacial  phos- 
phoric acid  are  employed,  is  prepared 
as  follows: — 

Calcine  the  oxide  of  zinc  for  two  hours, 
at  a  white  heat,  or  until  it  becomes  a 
hard,  yellowish  mass ;  then  pulverize  in  a 
mortar,  and  sieve  through  fine  bolting 
cloth.  For  the  liquid,  take  f,\  of 
Glacial  phosphoric  acid  (German)  in 
crystals,  and  dissolve  in  f^^j  of  water, 
and  then  evaporate  to  one-third,  on  a 
sand  bath. 


AUTHORITIES  CONSULTED 


Pharmacopoeia  of  the  United  States,  1882. 

Bartholow's  Materia  Medica  and  Therapeutics. 

United  States  Dispensatory. 

Braithwaite's  Retrospect. 

National  Dispensatory. 

Waring's  Practical  Therapeutics. 

Blakiston's  Physician's  Visiting  List. 

Biddle's  Materia  Medica. 

British  Pharmacopoeia. 

American  Journal  of  Medical  Sciences. 

London  Lancet. 

British  Medical  Journal. 

Medical  and  Surgical  Reporter. 

Stille's  Therapeutics  and  Materia  Medica. 

Taylor  on  Poisons. 

Tanner  on  Poisons. 

Wood's  Therapeutics,  Materia  Medica  and  Toxicology. 

Medical  Record. 

New  York  Medical  Journal. 

Medico-Chirurgical  Transactions. 

Ure's  Dictionary. 

Therapeutic  Handbook  of  the  United  States  Pharmacopoeia. 

Universal  Cyclopgedia — A.  McLane  Hamilton. 

Ellis'  Medical  Formulary. 

Compendium  of  Medical  Science. 

American  Journal  of  Dental  Science. 

Dental  Cosmos. 

Independent  Practitioner. 

Ohio  State  Journal  of  Dental  Science. 

London  Dental  Record. 

British  Journal  of  Dental  Science. 

Garrettson's  Oral  Surgery. 

Tanner's  Index  to  Diseases. 


299 


INDEX  TO  DENTAL  FORMULARY. 


PAGE 

ABSCESS  of  Antrum 156,  202 
Abraded  Surface  of  Mucous  Membrane  of  Mouth 126,  127,  157 

Acidity  and  Pyrosis 162 

Alkaline  Gargle 276 

Alveolar  Abscess 190,  202,  209,  223,  264,  279 

Hemorrhage 127,  187,  206 

Pyorrhcea 109,  123,  202 

Anodyne  Lotion 169 

Antiseptic  Dentifrice 108 

Gargle 121 

Lotion  or  Injection 107,  108,  279 

Aphthae 114,  123,  156,  178,  195,  209,  210,  227,  260,  276 

Aphthous  Ulcerations 276 

Astringent  Dentifrice 126 

Astringent  Lotion,  Gargle  or  Mouth  Wash 113,  121,    127 

BRUISES 130,  157 
Burns 121 

Bleaching  Discolored  Teeth 167 

CANCEROUS  Tumors 100 
Ulcerations 1 00 

Carbolized  Styptic 109 

Caries  of  Maxillary  Bones I17,  123,   195 

Chapped  Hands  and  Lips 255 

Chilblains 108 

Chronic  Abscesses  and  Ulcers 127 

Alveolar  Abscesses,  Ulcerations,  etc 209,  223 

Inflammation  of  Gums  and  Mucous  Membrane  91,  114,  126,  127,  146,   156, 

157,  226,  267 
Convulsions  of  Dentition 170 

DENTAL  Periostitis 130,  223 

Dentifrices 108,  126,  183,  191,  192 

Deodorizer  of  Iodoform 218 

Detergent  Mouth  Wash  or  Gargle., 267,  276 

Devitalizing  Pulps  of  Teeth 99,  100,  239 

DiaiThoea  of  Dentition 162,  215,  219,  239 

Disease  of  An tru m 1^6 

Disinfectant  Mouth  Wash  or  Gargle 107,  120 

Dysuria  of  Difficult  Dentition 231 

EARACHE  of  Dentition 181 

Ecchymosis 157 

Emollient  and  Antiseptic  Gargle 121 

Enlarged  Glands 219 

Excessive  Sweating  of  the  Hands 223 

301 


302  INDEX    TO    DENTAL    FORMULARY. 

FACIAL  Neuralgia 158,  169,  177,  181,  233,  270 
Febrile  Excitement  of  Dentition 215 

Fetor  of  Breath 167,  178,  228,  264 

Fetid  Perspiration 108 

Fissured  Tongue. 276 

Foul  and  Fetid  Idolent  Ulcers 176 

Fungous  Growths  and  Suppurating  Surfaces , 222 


G 


ANGRENE  of  Mouth  (Cancrum  Oris) 92,  167,  176,   195 

.^     Glycerole  of  Thymol.. 279 


HEMORRHAGE  from  Extraction  of  Teeth 127,  187,  206 
Hypertrophy  of  Tonsils 113 

Hypnotic 176 

INDIGESTION 253 
Indolent  Ulcers  of  Mouth 92,   176 

Infantile  Bilious  Diarrhoea 230 

Mucous  Diarrhoea 230 

Inflamed  Fauces  and  Throat 92,  262 

Mucous  Membrane  and  Gums 91,  113,  126,  127,  148,  156,  157,  209, 

210,  223,  226,  255,  260,  261,  262,  267 

Inflamed  and  Ulcerated  Gums 126,  127,  146,  209,  226,  255,  260,  261 

Internal  Astringent  in  Hemorrhagic  Affections 113 

Itching  of  Inflamed  Surfaces 238 

Itching  of  the  Skin 109 

LOCAL  Anaesthetics 130,  169,  176,  177,  180,  181 
Lotion  for  Soft  and  Spongy  Gums 107,  146 

MALIGNANT  Ulcerations ' 100 
Mercurial  Stomatitis 123,  144,  156,  178,  183,  223,  227,  228 

Mild  Detergent  Gargle 276 

nVTEURALGIA 130,  158,  169,  177,  180,  181,  218 

Xi  from  Dental  Disturbance 270 

in  Superficial  Nerves 159 

Neuralgic  Affections  of  the  Teeth 180,  181 

Odontalgia 193 

OBTUNDING  Mixture 130,  169,  176,  177,  180,  181,  239 
Odontalgia 108,  109,  126,  130,  146,  177,  i8r,  187,  190,  210,  218, 

233,  238,   239 

Offensive  Breath 167,  178,  228,  264 

Ointment  of  Iodoform  and  Eucalyptus 218 

Osseous  Tumors  of  the  Jaws 117 

Oxychloride  of  Zinc  Preparations 298 

Oxyphosphate  of  Zinc  Preparations 118,  298 

PAIN  Following  Extraction  of  Teeth 239 
Perspiration  of  Hands,  etc 121,  223 

Phagedenic  and  Sloughing  Ulcers 228 

Phenol  Sodique  Preparation 274 

Pulpitis 108,  109,  126,  130,  146,  177,  181,  187,  190,210,  219,  233,  238 

As  a  Capping  in 219 

Pulpless  Teeth 219,  253 


INDEX    TO    DENTAL    FORMULARY.  303 

RELAXED  Condition  of  Mucous  Membrane  of  Mouth  and  Gums 265 
Relaxation  of  Uvula II3 

Rigg's  Disease  (See  Alveolar  Pyorrhoea). 

SANDARACH  Solution 271 

Scorbutic  Gums 114 

Scurvy 92 

Sensitive    Dentine 126,  144 

Shellac  Solution 272 

Skin  Diseases 108 

Sloughing  and  111  Conditioned  Dicers 116 

Soft  and  Spongy  Gums 107,  146 

Sore  Throat , 146 

Stimulant  and  Antiseptic  Mouth  Wash  or  Lotion  107,  108,  120 

and  Antiseptic  Injection 108 

and  Anodyne  Lotion 169 

Stomatitis 178,  279 

Styptic 187 

Superficial  Inflammation 144 

Suppurating  Pulps  of  Teeth 201,  210,  219,  253,  264,  279 

Wounds 260 

Syphilitic  Ulceration  of  Mucous  Membrane  of  Mouth 108,  iil 


T 


ONSILITIS 113 

Tumors  of  Gums 218,  219 


XTLCERATED  Gums 126,  127,  146,  183,  209,  222,  260 

{J      Ulcerative  Stomatitis  114,  123,  126,  127,   146,    156,  157,   178,  183,   195, 

209,  222,  223,  227 

Ulcers  of  Mouth , 123,  126,  201,  260,  264 

over  Carious  Bone 117 

VENEREAL  Sore  Mouth  and  Throat 215 
Vomiting  and  Painful  Digestion  of  Children 162 

WARTS,  Condylomata,  etc 215 
Wash  after  Extraction  of  Teeth 183 

Wounds  and  Ulcers 108 


GENERAL  INDEX. 


PAGE 

ABBREVIATIONS 22 

Abnormal  Dentition 12 

Abnormal  Sensibility  of  Dentine...  20 

Abrasion  of  Teeth 20 

Abscess  of  Antrum 14 

Absolute  Alcohol 143,  144 

Absorbents 81 

Acacia 90 

Acetate  of  Alumina 147 

of  Ammonia  Solution 148 

of  Lead 253 

of  Morphine 235 

Acetic  Acid 91 

Acidum  Aceticum 91 

Arseniosum 92 

Benzoicum loi 

Carbolicum 103 

Chromicum 109 

Gallicum Ill 

Hydrochloricum 113 

Muriaticum 1 13 

Nitricum 114 

Nitricum  Dilutum 115 

Phosphoricum 116 

Salicylicum II9 

Sulphuricum , 121 

Sulphuricum  Aromaticum 122 

Tannicum 124 

Tartaricum 127 

Aconite 128 

Aconitum 128 

Action  of  Medicines lO 

Acute  Inflammation  of  DentalPulp  20 

^ther ....' 131 

Alcohol,.. 142 

Alteratives 74 

Alum 145 

Alumen 145 

Exsiccatum 146 

Aluminae  Acetas 147 

Aluminse  et  Ammonise  Sulphas....  146 

Aluminii  et  Potassii  Sulphas 146 

Alveolar  Abscess 13 

about  to  Point  Externally 14 

Pyorrhoea 19 

Ammonia  Alum 145 

Ammonii  Carbonas , 148 

Chloridum 150 

Valerianas 149 


Amyl  Nitris 151 

Amylene 151 

Anaesthetics 62 

Administration  of. 134 

Anodynes 61,  81 

Antacids 75 

Antemetics ,.  81 

Anthelmintics 80 

Anthridrotics 81 

Antilithics 75 

Antiperiodics 82 

Antiseptics 82 

Antispasmodics 62 

Aphthje 19 

Apothecaries'  Weight 25 

Appendix  to  Dental  Formulary 297 

Aqua  Acidi  Carbolic! 105 

Camphora 1 68 

Chlori 177 

Cinnamomi 184 

Creasoti 189 

Destillata 153 

Fortis 114 

Argenti  Nitras 153 

Aromatic  Sulphuric  Acid 122 

Arnica 156 

Arsenic,  Tests  for 100 

Arsenious  Acid 92 

Astri  ngents 63 

Atrophy  of  Teeth 20 

Atropinse  Sulphas 157 

Atropine 157 

Aurum  Terchloridum 159 

Avoirdupois  Weight 25 

BATHS 87 

Belladonnae  Folia 160 

Belladonna;  Radix 160 

Benzoated  Lard 102 

Benzoic  Acid lOi 

Bicarbonate  of  Potassium 257 

of  Sodium 274 

Bismuthi  Subnitras 161 

Bleaching  Discolored  Teeth 167 

Blenorrhetics 72 

Bloodletting,  General  and  Local...  290 

Blue  Stone 194 

Vitriol 1 94 

Borate  of  Sodium 27^ 


305 


306 


GENERAL   INDEX. 


PAGE 

Borax 275 

Bromide  of  Camphor 170 

of  Ethyl 196 

of  Potassium 257 

Butyl-Chloral  Hydrate  1 93 

CALCII  Hypophosphis 162 

Calcined  Magnesia 229 

Calcium 164 

Calendula 163 

Calisaya  Bark 181 

Calomel , 212 

Calx 164 

Chlorata 166 

Camphor 168 

Liniment 168 

Water 168 

Camphora 168 

Monobromata 170 

Camphorated  Tincture  of  Opium...  251 

Cantharidal  Collodion 186 

Carbolate  of  Sodium 273 

Capsicum 170 

Carbo  Animalis.  Purificatus 172 

Ligni .' 172 

Carbolic  Acid 103 

Water 105 

Carbonate  of  Ammonium 148 

of  Lime 190 

Caries,  Dental 21 

Carminatives 82 

Carvacrol 173 

Cassia  Bark 184 

Cataplasms 87 

Cathartics 68 

Caustic  Potassa 255 

Caustics 82 

Cauterants 77 

Cautery,  Actual  and  Potential 78 

Cayenne  Pepper 170 

Cerates.... 88 

Chalk  Mixture 191 

Characteristic    Indications   of  the 

Tongue 22 

Chloral 174 

Hydras 174 

Chlorate  of  Potassium 258 

Chloride  of  Ammonium 150 

of  Iron 203 

of  Zinc 284 

Chlorinated    Lime  —  Chloride    of 

Lime 166 

Chlorine 177 

Water 177 

Chlorinum 177 

Chloroform 178 


PAGE 

Chloroformum 178 

Chromic  Acid 109 

Chronic    Inflammation  of  Dental 

Pulp 20 

Cinchona  Flava 181 

Cinnamomum 1 84 

Cinnamon 184 

Water 184 

Classification    of  Medicinal    Sub- 

,    stances 61 

Cleft  Palate 18 

Clysters , 87 

Cobalt loi 

Collodion , 185 

Collodium 185 

cum  Cantharide 186 

Flexile 185 

lodidum 187 

Collyria 87 

Compound  Tincture  of  Iodine 221 

Coloring  Agents 80 

Condy's  Fluid 263 

Confections 87 

Constringents 82 

Convulsions  of  Dentition 12 

Corrosive  Chloride  of  Mercury 211 

Corrosive  Sublimate 212 

Counter-irritants 82 

Creasote 187 

Ointment 189 

"Water 189 

Creasotum 187 

Creta  Praeparata 190 

Croton- Chloral  Hydrate 193 

Cupping 292 

Cupri  Sulphas 194 

DANGERS  of  Anaesthesia 137 

Deadly  Nightshade 160 

Decimal  System  of  Weights  and 

Measures 25 

Decoction  of  White  Oak  Bark 266 

Decoctions 87 

Decoctum  Quercus  Albae 266 

Definition    of  Subjects — Materia 

Medica  and  Therapeutics..  9 
of  Various    Classes  of  Remedial 

Agents  61 

Demulcents 79 

Dental  Caries 21 

Periostitis 13 

Dentigerous  Cyst 17 

Deodorized  Tincture  of  Opium 251 

Deodorizers 83 

Desiccatives 82 

Detergents 8;^ 


GENERAL    INDEX. 


307 


PAGE 

Diaphoretics 71 

Dichloride  of  Ethidene 195 

Diluents 83 

Diluted  Solution  of  Subacetate  of 

Lead 255 

Discutients 83 

Disinfectants 83 

Dislocation  of  Lower  Jaw 17 

Distilled  Water    153 

Diuretics 72 

Doses  of  Medicines,  Table  of 31 

Drastics 69 

Dried  Alum , 146 

EFFERVESCING  Powders....  274 
Electricity  for  Relieving  Pain 

of  Extraction  of  Teeth 297 

Electricity  as  a  Therapeutic  Means 

in  the  Treatment  of  Disease  293 

Electuaries 87 

Elementary  Substances,  Table  of..     57 
Elixir  of  Vitriol  and  Tannic  Acid  125 

Emetics 66 

Em  menagogues 73 

Emollients S^ 

Emulsions 87 

Enemata 87 

Endermic  Method 289 

Epispasiics .-.     y6 

Epithelioma 19 

Epsom  Salt 230 

Epulis 19 

Errhines 84 

Eruption  of  the  Teeth 292 

Escharoiics 84 

Ether 131 

Ethidene  Dichloridum 195 

Ethyl  Bromidum 196 

Excitants 84 

Exostosis,  Dental 21 

Eucalyptol 200 

Eucalyptus 199 

Evacuants 84 

Expectorants 84 

Extracts 87 

Extractum  Gelsemii  Fluidum 207 

FACIAL  Paralysis 18 

Febrifuges 84 

Ferri  Chloridum 203 

Ferrum 202 

Fineness  of  Powder 24 

Fomentations 88 

Forms  of  Medicinal  Substances....  87 

Fracture  of  Alveolar  Process 15 


Fracture  of  Lower  Jaw 18 

French  Decimal  System  of  Weights 

and  Measures 25 

Fused  Potassa 255 

Fumigations 88 

GALLIC  Acid iii 
Cialls Ill 

Gargles 88 

Gelsemium 206 

General  Remarks 10 

Glacial  Phosphoric  Acid...  117 

Glycerin 207 

Glycerinum 207 

Pepsini 252 

Glycerite  of  Borate  of  Sodium 275 

of  Carbolic  Acid  105 

of  Gallic  Acid 112 

of  Tannic  AckI 126 

Glycerites 88 

Glyceritum  Acidi  Carbolici 105 

Acidi  Gallici 112 

Acidi  Tannici 126 

Sodii  Boratis 275 

Glycerole  of  Thymol  279 

Gum  Arabic 90 

Gutta  Percha 224 

H^MATINICS 73 
Haemostatics 85 

Hamamelis 210 

Hare  Lip 18 

Hall's  (Marshall)   Ready  Method 

in  Asphyxia 140 

Hemorrhage    Following   the   Ex- 
traction of  Teeth 205 

Hoffman's  Anodyne 132 

Honey  of  Borate  of  Sodium 275 

Hirudo 291 

Hydrargyri  Chloridum  Corrosivum  21 T 

Chloridum  Mite 212 

Hydrargyrum 211 

cum  Creta 214 

Hydragogues 68 

Hydrate  of  Chloral 174 

of  Potash 255 

Hydrochlorate  of  Ammonia 150 

of  Morphine 235 

Hydrochloric  Acid 113 

Hydrobromic  Ether 196 

Hypersthenics 85 

Hypertrophy  of  Alveolar  Processes     20 

of  Gums 19 

Hypnotics 85 

Hypodermic  Method 289 

Hypophosphite  of  Quinine 269 


308 


GENERAL    INDEX. 


PAGE 

IMPACTED  TOOTH 17 
Important  Points  in  Diagnos- 
ing Affections  of  the  Mouth  12 
Inflammation  of  Dental  Periosteum  1 3 

of  Dental  Pulp 20 

of  Mucous  Membrane  of  the 

Mouth,  Syphilitic 16 

Inhalants 88 

Injections 88 

Infusions 88 

Infusum  Capsici 171 

Iodide  of  Potassium 220 

Iodine 219 

Iodized  Collodion 187 

Iodoform 215 

lodoformum 215 

lodum 219 

losandra  Gutta 224 

Iridis  Rhizome 223 

Iron 202 

Irritants 7^ 

Irritation  of  Dental  Pulp 19 

of  Teething 12 

TAP ANESE  Camphor 232 

TXRAMERIA 225 

LABARRAQUE'S   Solution....  226 
Lacmus ..   228 

Laudanum 251 

Laughing  Gas 240 

Laxatives , 85 

Lead  Poisoning 15 

Water 255 

Leeches 291 

Lentitives 79 

Leopard's  Bane 156 

Lime 164 

Liniment 165 

Water 164 

Liniments 88 

Linimentum  Calcis 165 

Camphorse 168 

Saponis 168 

Liquor  Ammonii  Acetatis 148 

Calcis 164 

Ferri  Perchloridi 204 

Ferri  Subsulphatis 204 

Gutta  Percha 225 

Plumbi  Subacetatis  Dilutus...  255 

Potassii  Arsenitis 95 

Sodffi  Chloratis 226 

Listerine 102 

Lithontriptics 75 


PAGE 

Litmus 228 

Local  Ansesthesia 141 

Lotions 88 

Lunar  Caustic 153 

MAGNESIA 229 
Magnesii  Sulphas 230 

Marigold 163 

Matico , 231 

Measurement  of   Medicinal    Sub- 
stances      23 

Menthol 232 

Mel  Boracis 275 

Mercury, 21 1 

with  Chalk 214 

Mercurial  Ointment 214 

Poisoning 15 

Mercuric  Chloride 212 

Mercurous  Chloride 212 

Methyl  Ether 233 

Methyl-Ethylic  Ether 233 

Metric    System   of    Weights   and 

Measures 25 

Mild  Chloride  of  Mercury 212 

Mistura  Cretse , 191 

Mixtures 88 

Monobromated  Camphor 170 

Monsel's  Solution  and  Powder 204 

Morphina 234 

Morphinas  Acetas 235 

Hydrochloras  or  Murias 235 

Sulphas 236 

Morphine 234 ' 

Muriate  of  Ammonia 150 

of  Morphine 235 

Myrrh 239 

Myrrha 239 

"TVTARCOTICS 61 

IM       Nasal  Polypus 18 

Nauseants 67 

Necrosis  of  Alveolar  Processes 14 

of  Jaw 17 

Nelaton's  Method  of  Resuscitation  138 

Nervines 85 

Nitrate  of  Silver 153 

of  Potassium , 261 

Nitre 261 

Nitric  Acid 114 

Nitrite  of  Amyl 151 

Nitrous  Oxide 240 

Nutritives 85 

ODONTOMES 21 
Oleum  Amygdala  Dulcis...   246 

Oleum  Cajuputi 247 

Camphorse 169 


GENERAL    INDEX. 


309 


PAGE 

Oleum  Caryophilli 247 

Cinnamomi 1 84 

Eucalypti 200 

OilofCajuput 247 

of  Camphor 169 

of  Cinnamon 184 

of  Cloves 247 

of  Sweet  Almonds 246 

of  Vitriol 121 

Ointment  of  Carbolic  Acid  105 

of  Galls 112 

of  Tannic  Acid 126 

Ointments 88 

Opium 249 

Orris  Rhizome 223 

Root 223 

Ossification  of  Dental  Pulp 20 

Oxide  of  Potassium 255 

of  Zinc 287 

PELLITORY 264 

Peppermint  Camphor 232 

Pepsin  251 

Pepsinum 251 

Saccharatum 252 

Permanganate  of  Potassium 262 

Peruvian  Bark 181 

Phenate  of  Sodium 273 

Phenol  Sodique 273 

Phosphor  Necrosis 15 

Phosphoric  Acid 116 

in  the  Anhydrous  State I17 

Pills 88 

Plasters 88 

Plumbi  Acetas 253 

Poisons 46 

Symptoms  and  Antidotes  for, 

Acids,  Mineral 47 

Aconite 47 

Alkalies 47 

Antimony 47 

Arsenious  Acid 47 

Atropine 48 

Belladonna 48 

Cannabis  Indica 48 

Cantharides 48 

Carbolic  Acid 4J< 

Chloral 49 

Chlorine  Water 49 

Chloroform 49 

Conium 50 

Copper,  Sulphate  of 50 

Corrosive  Sublimate 50 

Creasote 50 

Croton  Oil 50 

Digitalis ' 50 

Hydrocyanic  Acid 51 


riyoscyamus 

Iodine 

Lead  Salts 

Mercury 

Morphine 

Nux  Vomica  

Opium 

Oxalic  Acid 

Ph  osphorus 

Potash  and  Soda  Salts 

Silver,  Nitrate  of 

Stramonium 

Strychnine 

Tobacco 

Zinc  Salts 

Posological  Tables 

Potassa  Alum 

Caustica 

Potassii  Bicarbonas 

Chloras 

lodidum 

Nitras 

Permanganas 

Powdered  Subsulphate  of  Iron 

Preventive  Measures  against  dan- 
gers of  Anaesthesia 

Precipitated  Chalk 

Prepared  Chalk 

Prickly  Ash 

Protectives 

Protoxide  of  Nitrogen 

Pulse,  the 

Variations   in,  Frequency  of... 

Pulvis  Ferri  Subsulphatis 

Purgatives 

Purified  Animal  Charcoal 

Pyorrhoea,  Alveolar 

Pyrethrum 


51 
5' 
51 
51 

51 

52 
52 
52 
52 
52 
52 
53 
53 
53 
53 
31 
146 

255 
257 
258 
220 
261 
262 
204 

137 
190 
190 
283 
83 
240 

53 

54 

204 

85 
172 

19 

264 


QUERCUS  Alba... 265 

Quicksilver 21 1 

Quillaya  Saponaria 266 

Quillaia  Bark 266 

Quininse   Sulphas 268 

Hypophosphis 269 

Sulphas 182 

Quinine 182 

REFRIGERANTS 85 

Resolvents 85 

Respiration  at  Various  Ages 56 

Restoratives 86 

Resuscitation,  Methods  of 139 

Riggs'   Disease 19 

Rhatany 225 

Rhigolene 270 

Rubefacients 76 


310 


GENERAL    INDEX. 


PAGE 

Rules  for  Administering  Ansesthet- 

ics 136 

Rules  for  Regulating  Doses 29 

SAL  Ammoniac 150 
Salicylic  Acid 119 

Salivation 15 

Saltpetre 261 

Sandaraca 271 

Sandarach 271 

Scarifications 292 

Scurvy 15 

Sedatives 65 

Sesquicarbonate  of  Soda 274 

Setons  and  Issues 290 

Shellac 272 

Sialagogues 86 

Soap  Liniment 168 

Sodii  Bicarbonas 274 

Boras 275 

Phenas 273 

Solubility  of  Chemicals  in  Water 

and  Alcohol 58 

Solution  of  Acetate  of  Ammonia..  148 

of  Chlorinated  Soda 226 

of  Chloride  of  Zinc 285 

of  Gutta  Percha 225 

of  Subsulphate  of  Iron 204 

Soporifics 61 

S.  Am.  Soap  Tree  Bark 266 

Spastics 66 

Spirit  of  Chloroform 180 

of  Cinnamon 184 

of  Nitrous  Ether 132 

of  Mindererus I48 

Spiritus  y^itheris  Compositus 132 

^theris  Nitrosi 132 

Camphorse 168 

Chloroformi 1 80 

Cinnamomi 184 

Spinants 66 

Stimulants 64 

Stomatitis 16 

Stomachics 65 

Stomatitis  Gangrenous 17 

Ulcerative 16 

Mercurial 15 

Styptics 86 

Styptic  Colloid 125 

Subnitrate  of  Bismuth 161 

Sugar  of  Lead 253 

Sudorifics 71 

Sulphate  of  Atropine 157 

of  Copper 194 

of  Magnesium 230 

of  Morphine 236 


PAGE 

Sulphate  of  Quinine 268 

of  Zinc 287 

Sulpho-Carbolates  of  Zinc,  Sodium, 
Potassium,  Magnesium,  Cal- 
cium and  Quinine 105 

Sulpho-Carbolic  Acid 105 

Sulphuric  Acid 121 

Sulphuric  Ether 131 

Suppositories 89 

Suppurants, 77 

Sylvester's  Method  of  Resuscita- 
tion    139 

Syphilitic  Inflammation  of  Mouth..  16 

Syphilitic  Teeth 21 

Syrups 89 

TABLE  of  Doses  of  Medicines  31 

of  Equivalents 28 

Tannic  Acid 124 

Tartaric  Acid 127 

Terchloride  of  Gold 159 

Terchloride  of  Phenol 277 

Teriodide  of  Formyl 215 

Thermometers 56 

Thrush 19 

Thymol 278 

Tinctura    Aconiti ,  129 

Arnica 156 

Calendula 164 

Capsici 171 

Eucalypti 201 

Gelsemii 207 

lodi  221 

lodi  Composita 221 

Kramerise 226 

Myrrhse 240 

Opii 251 

Opii  Camphorata 251 

Opii  Deodorata 251 

Pyrethri 265 

Tinctures 89 

Tonics 63 

Treatment  of  Dangerous  Symp- 
toms  of  Anaesthesia 138 

Troches  of  Chlorate  of  Potassium  259 

Troy  Weight 25 

Tumor  of  Jaws,   Malignant  form 

of 17 

Tumor  of  Upper  Jaws 17 

ULCERS  of  Mouth,  Syphilitic     16 
Unguentum  Acidi  Carbolic!  105 

Unguentum  Acidi  Tannici 126 

Creasoti 189 

Gallse 112 

Hydrargyri 112 


GENERAL    INDEX. 


Ill 


PAGE 

VALERIANATE    of   Ammo- 
nium    149 

Vaselin 280 

Vaseline 280 

Veratrina 281 

Veratrine 281 

Vesicants  87 

Vinum  Opii 251 

Pepsini 252 

WEIGHTS  and  Measures 25 
White  Oak  Bark 265 


PACE 

Witch  Hazel 210 

Wood  Charcoal 172 

VANTHOXYLUiM 283 

YELLOW  Cinchona 181 
Jasmine 206 

ZINCI  Chloridum..... 284 
Oxidum 287 

Sulphas 287 


